Sample records for absorb 2-year outcomes

  1. Two years' outcome of thread lifting with absorbable barbed PDO threads: Innovative score for objective and subjective assessment.

    PubMed

    Ali, Yasser Helmy

    2018-02-01

    Thread-lifting rejuvenation procedures have evolved again, with the development of absorbable threads. Although they have gained popularity among plastic surgeons and dermatologists, very few articles have been written in literature about absorbable threads. This study aims to evaluate two years' outcome of thread lifting using absorbable barbed threads for facial rejuvenation. Prospective comparative stud both objectively and subjectively and follow-up assessment for 24 months. Thread lifting for face rejuvenation has significant long-lasting effects that include skin lifting from 3-10 mm and high degree of patients' satisfaction with less incidence rate of complications, about 4.8%. Augmented results are obtained when thread lifting is combined with other lifting and rejuvenation modalities. Significant facial rejuvenation is achieved by thread lifting and highly augmented results are observed when they are combined with Botox, fillers, and/or platelet rich plasma (PRP) rejuvenations.

  2. One-year clinical outcomes of patients treated with everolimus-eluting bioresorbable vascular scaffolds versus everolimus-eluting metallic stents: a propensity score comparison of patients enrolled in the ABSORB EXTEND and SPIRIT trials.

    PubMed

    de Ribamar Costa, José; Abizaid, Alexandre; Bartorelli, Antonio L; Whitbourn, Robert; Jepson, Nigel; Perin, Marco; Steinwender, Clemens; Stuteville, Marrianne; Ediebah, Divine; Sudhir, Krishnankutty; Serruys, Patrick W

    2016-11-20

    We sought to compare the outcomes of low/moderate complexity patients treated with the Absorb BVS from the ABSORB EXTEND trial with patients treated with the XIENCE everolimus-eluting stent (EES), using propensity score (PS) matching of pooled data from the SPIRIT trials (SPIRIT II, SPIRIT III, SPIRIT IV) and the XIENCE V USA trial. ABSORB EXTEND was a prospective, single-arm, open-label clinical study in which 812 patients were enrolled at 56 sites. This study allowed the treatment of lesions ≤28 mm in length and with a reference vessel diameter of 2.0-3.8 mm (as assessed by online QCA). The propensity score was obtained by fitting a logistic regression model with the cohort indicator as the binary outcome and other variables as the predictor variables. At one-year clinical follow-up, there was no statistical difference between groups with regard to MACE (5.0% vs. 4.8%, p=0.83), target lesion failure (5.0% vs. 4.7%, p=0.74), ischaemia-driven target vessel revascularisation (2.3% vs. 3.0%, p=0.38) and device thrombosis (1.0% vs. 0.3%, p=0.11). Myocardial infarction was higher with Absorb (3.3% vs. 1.5%, p=0.02), at the expense of periprocedural CK-MB elevation. Independent predictors of MACE among patients receiving Absorb BVS were treatment of multivessel disease, insulin-dependent diabetes and performance of post-dilation. At one-year follow-up, propensity score-matched analysis demonstrated that the clinical safety and effectiveness of Absorb are comparable to those of XIENCE EES among non-complex patients treated with PCI.

  3. 1-year clinical outcomes of diabetic patients treated with everolimus-eluting bioresorbable vascular scaffolds: a pooled analysis of the ABSORB and the SPIRIT trials.

    PubMed

    Muramatsu, Takashi; Onuma, Yoshinobu; van Geuns, Robert-Jan; Chevalier, Bernard; Patel, Tejas M; Seth, Ashok; Diletti, Roberto; García-García, Hector M; Dorange, Cécile C; Veldhof, Susan; Cheong, Wai-Fung; Ozaki, Yukio; Whitbourn, Robert; Bartorelli, Antonio; Stone, Gregg W; Abizaid, Alexandre; Serruys, Patrick W

    2014-05-01

    The aim of this study was to evaluate 1-year clinical outcomes of diabetic patients treated with the Absorb bioresorbable vascular scaffold (BVS). Clinical outcomes of diabetic patients after BVS implantation have been unreported. This study included 101 patients in the ABSORB Cohort B trial and the first consecutive 450 patients with 1 year of follow-up in the ABSORB EXTEND trial. A total of 136 diabetic patients were compared with 415 nondiabetic patients. In addition, 882 diabetic patients treated with everolimus-eluting metal stents (EES) in pooled data from the SPIRIT trials (SPIRIT FIRST [Clinical Trial of the Abbott Vascular XIENCE V Everolimus Eluting Coronary Stent System], SPIRIT II [A Clinical Evaluation of the XIENCE V Everolimus Eluting Coronary Stent System], SPIRIT III [Clinical Trial of the XIENCE V Everolimus Eluting Coronary Stent System (EECSS)], SPIRIT IV Clinical Trial [Clinical Evaluation of the XIENCE V Everolimus Eluting Coronary Stent System]) were used for the comparison by applying propensity score matching. The primary endpoint was a device-oriented composite endpoint (DoCE), including cardiac death, target vessel myocardial infarction, and target lesion revascularization at 1-year follow-up. The cumulative incidence of DoCE did not differ between diabetic and nondiabetic patients treated with the BVS (3.7% vs. 5.1%, p = 0.64). Diabetic patients treated with the BVS had a similar incidence of the DoCE compared with diabetic patients treated with EES in the matched study group (3.9% for the BVS vs. 6.4% for EES, p = 0.38). There were no differences in the incidence of definite or probable scaffold/stent thrombosis (0.7% for both diabetic and nondiabetic patients with the BVS; 1.0% for diabetic patients with the BVS vs. 1.7% for diabetic patients with EES in the matched study group). In the present analyses, diabetic patients treated with the BVS showed similar rates of DoCEs compared with nondiabetic patients treated with the BVS and

  4. Comparison of cosmetic outcomes of absorbable versus nonabsorbable sutures in pediatric facial lacerations.

    PubMed

    Luck, Raemma; Tredway, Trevor; Gerard, James; Eyal, Dalit; Krug, Lauren; Flood, Robert

    2013-06-01

    We sought to compare cosmetic outcomes, complication rates, and patient/caregiver satisfaction of absorbable versus nonabsorbable sutures in children. Healthy patients, 1 to 18 years old, with facial lacerations 1 to 5 cm, were randomized to repair with fast-absorbing catgut (FAC) or nylon (NYL) sutures. Patients returned in 4 to 7 days and in 3 to 4 months, at which time photographs and caregiver surveys were completed. Unlike part I, all FAC sutures were permitted to absorb rather than be removed. Using a 100-mm visual analog scale (VAS), a noninferiority (NI) design was applied, with a difference of less than 15 mm considered clinically equivalent. Caregivers and 3 blinded physicians independently rated the scars via photographs. Ninety-eight patients were enrolled, 76 caregiver surveys were completed, and 61 (29 FAC, 32 NYL) had photographs scored by physicians. The mean physician VAS scores for FAC and NYL were 57.6 and 67.6, respectively (difference, -10.0; 95% confidence interval, -19.1 to -0.4); thus, NI could not be established. The mean caregiver VAS scores for the FAC and NYL groups were 93.8 and 86.6, respectively (difference, 7.2; 95% confidence interval, -4.9 to 13.9); thus, NI of FAC was established. There were no significant differences in rates of infection, wound dehiscence, or keloid formation. In terms of future preference, caregivers favored FAC (33/33) over NYL (26/36) (P < 0.01). Caregiver VAS scores showed NI of FAC, which were also preferred by the caregivers. However, NI for FAC could not be demonstrated by blinded physicians with respect to cosmetic outcomes.

  5. Does Extended Preoperative Rehabilitation Influence Outcomes 2 Years After ACL Reconstruction?

    PubMed Central

    Failla, Mathew J.; Logerstedt, David S.; Grindem, Hege; Axe, Michael J.; Risberg, May Arna; Engebretsen, Lars; Huston, Laura J.; Spindler, Kurt P.; Snyder-Mackler, Lynn

    2017-01-01

    Background Rehabilitation before anterior cruciate ligament (ACL) reconstruction (ACLR) is effective at improving postoperative outcomes at least in the short term. Less is known about the effects of preoperative rehabilitation on functional outcomes and return-to-sport (RTS) rates 2 years after reconstruction. Purpose/Hypothesis The purpose of this study was to compare functional outcomes 2 years after ACLR in a cohort that underwent additional preoperative rehabilitation, including progressive strengthening and neuromuscular training after impairments were resolved, compared with a nonexperimental cohort. We hypothesized that the cohort treated with extended preoperative rehabilitation would have superior functional outcomes 2 years after ACLR. Study Design Cohort study; Level of evidence, 3. Methods This study compared outcomes after an ACL rupture in an international cohort (Delaware-Oslo ACL Cohort [DOC]) treated with extended preoperative rehabilitation, including neuromuscular training, to data from the Multicenter Orthopaedic Outcomes Network (MOON) cohort, which did not undergo extended preoperative rehabilitation. Inclusion and exclusion criteria from the DOC were applied to the MOON database to extract a homogeneous sample for comparison. Patients achieved knee impairment resolution before ACLR, and postoperative rehabilitation followed each cohort's respective criterion-based protocol. Patients completed the International Knee Documentation Committee (IKDC) subjective knee form and Knee injury and Osteoarthritis Outcome Score (KOOS) at enrollment and again 2 years after ACLR. RTS rates were calculated for each cohort at 2 years. Results After adjusting for baseline IKDC and KOOS scores, the DOC patients showed significant and clinically meaningful differences in IKDC and KOOS scores 2 years after ACLR. There was a significantly higher (P < .001) percentage of DOC patients returning to preinjury sports (72%) compared with those in the MOON cohort (63

  6. Risk and timing of clinical events according to diabetic status of patients treated with everolimus-eluting bioresorbable vascular scaffolds versus everolimus-eluting stent: 2-year results from a propensity score matched comparison of ABSORB EXTEND and SPIRIT trials.

    PubMed

    Campos, Carlos M; Caixeta, Adriano; Franken, Marcelo; Bartorelli, Antonio L; Whitbourn, Robert J; Wu, Chiung-Jen; Li Paul Kao, Hsien; Rosli, Mohd Ali; Carrie, Didier; De Bruyne, Bernard; Stone, Gregg W; Serruys, Patrick W; Abizaid, Alexandre

    2018-02-15

    to compare the occurrence of clinical events in diabetics treated with the Absorb bioresorbable vascular scaffold (Absorb BVS; Abbott Vascular, Santa Clara, CA) versus everolimus-eluting metal stents (EES; XIENCE V; Abbott Vascular, Santa Clara, CA) BACKGROUND: There are limited data dedicated to clinical outcomes of diabetic patients treated with bioresorbable scaffolds (BRS) at 2-year horizon. The present study included 812 patients in the ABSORB EXTEND study in which a total of 215 diabetic patients were treated with Absorb BVS. In addition, 882 diabetic patients treated with EES in pooled data from the SPIRIT clinical program (SPIRIT II, SPIRIT III and SPIRIT IV trials) were used for comparison by applying propensity score matching using 29 different variables. The primary endpoint was ischemia driven major adverse cardiac events (ID-MACE), including cardiac death, myocardial infarction (MI), and ischemia driven target lesion revascularization (ID-TLR). After 2 years, the ID-MACE rate was 6.5% in the Absorb BVS vs. 8.9% in the Xience group (P = 0.40). There was no difference for MACE components or definite/probable device thrombosis (HR: 1.43 [0.24,8.58]; P = 0.69). The occurrence of MACE was not different for both diabetic status (insulin- and non-insulin-requiring diabetes) in all time points up to the 2-year follow-up for the Absorb and Xience groups. In this largest ever patient-level pooled comparison on the treatment of diabetic patients with BRS out to two years, individuals with diabetes treated with the Absorb BVS had a similar rate of MACE as compared with diabetics treated with the Xience EES. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  7. Clinical outcomes of patients with diabetes mellitus treated with Absorb bioresorbable vascular scaffolds: a subanalysis of the European Multicentre GHOST-EU Registry.

    PubMed

    Capranzano, Piera; Capodanno, Davide; Brugaletta, Salvatore; Latib, Azeem; Mehilli, Julinda; Nef, Holger; Gori, Tommaso; Lesiak, Maciej; Geraci, Salvatore; Pyxaras, Stelios; Mattesini, Alessio; Münzel, Thomas; Araszkiewicz, Aleksander; Caramanno, Giuseppe; Naber, Christoph; Di Mario, Carlo; Sabatè, Manel; Colombo, Antonio; Wiebe, Jens; Tamburino, Corrado

    2018-02-15

    Data on the clinical performance of bioresorbable scaffolds in patients with diabetes mellitus (DM) are still limited. The present study reported 1-year clinical outcomes associated with the use of everolimus-eluting bioresorbable vascular scaffolds (Absorb BVS; Abbott Vascular, Santa Clara, CA) in DM patients. This was a subanalysis from the GHOST-EU (Gauging coronary Healing with biOresorbable Scaffolding plaTforms in Europe) multicenter retrospective registry including patients treated with Absorb BVS between November 2011 and September 2014. In this study, a comparative analysis stratified according to DM was performed. The primary endpoint was target lesion failure (TLF), defined as the combination of cardiac death, target-vessel myocardial infarction (MI) and clinically-driven target-lesion revascularization (TLR). A total of 1,477 patients were treated with 2,224 Absorb BVS; 381 (25.8%) and 1,096 (74.2%) patients were with and without DM, respectively. The 1-year rate of TLF was higher among patients with DM (7.8%) than those without DM (4.3%); the increase in TLF was driven by TLR (6.5% vs. 3.3%, P = 0.009); no significant differences in cardiac death (1.1% vs. 0.9%, P = 0.68) and target-vessel MI (3.1% vs. 2.2%, P = 0.38) were observed, respectively. Definite/probable scaffold thrombosis rate tended to be higher among patients with DM than those without DM (3.0% vs. 1.7%, P = 0.14, respectively). Absorb BVS use in patients with DM was associated with increased 1-year TLF and scaffold thrombosis compared with non-diabetes patients. © 2017 Wiley Periodicals, Inc.

  8. Crestal Sinus Augmentation with Recombinant Human Bone Morphogenetic Protein 2: Clinical and Radiographic Outcomes of 2-Year Pilot Trial.

    PubMed

    Kuchler, Ulrike; Rudelstorfer, Claudia M; Barth, Barbara; Tepper, Gabor; Lidinsky, Dominika; Heimel, Patrick; Watzek, Georg; Gruber, Reinhard

    Recombinant human bone morphogenetic protein 2 (rhBMP-2) together with an absorbable collagen carrier (ACS) was approved for augmentation of the maxillary sinus prior to implant placement. The original registration trial was based on a lateral window approach. Clinical outcomes of crestal sinus augmentation with rhBMP-2 have not been reported so far. An uncontrolled pilot trial in which seven patients with a residual maxillary height below 5 mm were enrolled to receive crestal sinus augmentation with rhBMP-2/ACS was conducted. Elevation of the sinus mucosa was performed by gel pressure. Primary endpoints were the gain in augmentation height and volume measured by computed tomography after 6 months. Evaluation of bone quality at the time of implant placement was based on histology. Secondary endpoints were the clinical and radiologic evaluation of the implants and patient satisfaction by visual analog scale (VAS) at the 2-year follow-up. Median gain in augmentation height was 7.2 mm (range 0.0 to 17.5 mm). Five patients gained at least 5 mm of bone height. Two patients with a perforation of the sinus mucosa failed to respond to rhBMP-2/ACS and underwent lateral window augmentation. The median gain in augmentation volume of the five patients was 781.3 mm³ (range 426.9 to 1,242.8 mm³). Biopsy specimens showed a cancellous network consisting of primary plexiform bone with little secondary lamellar bone. After 2 years, implants were in function with no signs of inflammation or peri-implant bone loss. Patients were satisfied with the esthetic outcomes and chewing function. This pilot clinical trial supports the original concept that rhBMP-2/ACS supports bone formation, also in crestal sinus augmentation, and emphasizes the relevance of the integrity of the sinus mucosa to predict the bone gain.

  9. Relative size predicts competitive outcome through 2 million years.

    PubMed

    Liow, Lee Hsiang; Di Martino, Emanuela; Krzeminska, Malgorzata; Ramsfjell, Mali; Rust, Seabourne; Taylor, Paul D; Voje, Kjetil L

    2017-08-01

    Competition is an important biotic interaction that influences survival and reproduction. While competition on ecological timescales has received great attention, little is known about competition on evolutionary timescales. Do competitive abilities change over hundreds of thousands to millions of years? Can we predict competitive outcomes using phenotypic traits? How much do traits that confer competitive advantage and competitive outcomes change? Here we show, using communities of encrusting marine bryozoans spanning more than 2 million years, that size is a significant determinant of overgrowth outcomes: colonies with larger zooids tend to overgrow colonies with smaller zooids. We also detected temporally coordinated changes in average zooid sizes, suggesting that different species responded to a common external driver. Although species-specific average zooid sizes change over evolutionary timescales, species-specific competitive abilities seem relatively stable, suggesting that traits other than zooid size also control overgrowth outcomes and/or that evolutionary constraints are involved. © 2017 John Wiley & Sons Ltd/CNRS.

  10. [Study of new blended chemical absorbents to absorb CO2].

    PubMed

    Wang, Jin-Lian; Fang, Meng-Xiang; Yan, Shui-Ping; Luo, Zhong-Yang; Cen, Ke-Fa

    2007-11-01

    Three kinds of blended absorbents were investigated on bench-scale experimental bench according to absorption rate and regeneration grade to select a reasonable additive concentration. The results show that, among methyldiethanolamine (MDEA) and piperazine (PZ) mixtures, comparing MDEA : PZ = 1 : 0.4 (m : m) with MDEA : PZ = 1 : 0.2 (m : m), the absorption rate is increased by about 70% at 0.2 mol x mol(-1). When regeneration lasting for 40 min, regeneration grade of blended absorbents with PZ concentration of 0.2, 0.4, and 0.8 is decreased to 83.06%, 77.77% and 76.67% respectively while 91.04% for PZ concentration of 0. MDEA : PZ = 1 : 0.4(m : m) is a suitable ratio for MDEA/PZ mixtures as absorption and regeneration properties of the blended absorbents are all improved. The aqueous blends with 10% primary amines and 2% tertiary amines could keep high CO2 absorption rate, and lower regeneration energy consumption. Adding 2% 2-Amino-2-methyl-1-propanol (AMP) to 10% diethanolamine (DEA), the blended amine solvents have an advantage in absorption and regeneration properties over other DEA/AMP mixtures. Blended solvents, which consist of a mixture of primary amines with a small amount of tertiary amines, have the highest absorption rate among the three. And mixed absorbents of secondary amines and a small amount of sterically hindered amines have the best regeneration property. To combine absorption and regeneration properties, blends with medium activator addition to tertiary amines are competitive.

  11. Cosmetic outcomes of absorbable versus nonabsorbable sutures in pediatric facial lacerations.

    PubMed

    Luck, Raemma P; Flood, Robert; Eyal, Dalit; Saludades, John; Hayes, Ciana; Gaughan, John

    2008-03-01

    We sought to compare the long-term cosmetic outcomes of absorbable versus nonabsorbable sutures for facial lacerations in children and to compare the complication rates and parental satisfaction in the 2 groups. Healthy patients presenting to a pediatric emergency department with facial lacerations were randomized to repair using fast-absorbing catgut or nylon suture. Patients were followed up at 5 to 7 days and at 3 months. Three blinded observers, using a previously validated 100-mm cosmesis visual analogue scale (VAS) as the primary instrument, rated photographs of the wound taken at 3 months. For this noninferiority study, a VAS score of 15 mm or greater was considered to be the minimal clinically important difference. Parents also rated the wound using the VAS and completed a satisfaction survey. Of the 88 patients initially enrolled, 47 patients completed the study: 23 in the catgut group and 24 in the nylon group. There were no significant differences in age, race, sex, wound length, number of sutures, and layered repair rates in the 2 groups. The observers' mean VAS for the catgut group was 92.3 (95% confidence interval [CI], 89.1-95.4) and that for the nylon group was 93.7 (95% CI, 91.4-96.0), with a difference of the means of 1.4 (95% CI, -5.31 to 8.15), which was less than the minimal clinically important difference of 15 mm (power, >90%). The mean parental VAS score for the catgut group was 86.3 (95% CI, 78.4-94.1) and that for the nylon group was 91.2 (95% CI, 86.9-95.4), with a difference of the means of 4.9 (95% CI, 2.41-7.41), also less than 15 mm. There were no significant differences in the rates of infection, wound dehiscence, keloid formation, and parental satisfaction. The use of fast-absorbing catgut suture is a viable alternative to nonabsorbable suture in the repair of facial lacerations in children.

  12. Motor testing at 1 year improves the prediction of motor and mental outcome at 2 years after perinatal hypoxic-ischaemic encephalopathy.

    PubMed

    van Schie, Petra E M; Becher, Jules G; Dallmeijer, Annet J; Barkhof, Frederik; Van Weissenbruch, Mirjam M; Vermeulen, R Jeroen

    2010-01-01

    To investigate the predictive value of motor testing at 1 year for motor and mental outcome at 2 years after perinatal hypoxic-ischaemic encephalopathy (HIE) in term neonates. Motor and mental outcome at 2 years was assessed with the Bayley Scales of Infant Development, 2nd edition (BSID-II) in 32 surviving children (20 males, 12 females; mean gestational age 40.2 wk, SD 1.4; mean birthweight 3217g, SD 435) participating in a prospective cohort study of HIE. The predictive value of three motor tests (Alberta Infant Motor Scale [AIMS], BSID-II, and the Neurological Optimality Score [NOS]) at 1 year was analysed, in addition to predictions based on neonatal Sarnat staging and magnetic resonance imaging (MRI). Poor motor test results were defined as an AIMS z-score of <-2, a psychomotor developmental index of the BSID-II of <70, or a NOS of <26. Poor motor and poor mental outcome at 2 years was defined as a psychomotor developmental index or mental developmental index of the BSID-II of <70. Twelve children, all with Sarnat grade II, had a poor motor outcome and 12 children, of whom one had Sarnat grade I, had a poor mental outcome at 2 years. Nine children had cerebral palsy, of whom five had quadriplegia, three had dyskinesia, and one had hemiplegia. Poor motor tests at 1 year increased the probability of a poor motor outcome from 71% (range 92 to 100%), and a poor mental outcome from 59% (range 77 to 100%) in children with Sarnat grade II and abnormal MRI, assessed with the AIMS and BSID-II or NOS respectively. Additional motor testing at 1 year improves the prediction of motor and mental outcome at 2 years in children with Sarnat grade II and abnormal MRI.

  13. Efficacy and Safety of the Absorb Everolimus-Eluting Bioresorbable Scaffold for Treatment of Patients With Diabetes Mellitus: Results of the Absorb Diabetic Substudy.

    PubMed

    Kereiakes, Dean J; Ellis, Stephen G; Kimura, Takeshi; Abizaid, Alexandre; Zhao, Weiying; Veldhof, Susan; Vu, Minh-Thien; Zhang, Zhen; Onuma, Yoshinobu; Chevalier, Bernard; Serruys, Patrick W; Stone, Gregg W

    2017-01-09

    The study sought to evaluate the efficacy and safety of the Absorb everolimus-eluting bioresorbable vascular scaffold (BVS) (Abbott Vascular, Abbott Park, Illinois) in patients with diabetes mellitus. Randomized, controlled trials have demonstrated comparable clinical outcomes following percutaneous coronary intervention with either Absorb BVS or metallic Xience everolimus-eluting stent. However, these trials lack power required to provide reliable treatment effect estimates in this high-risk population. In a pre-specified, powered analysis, patients with diabetes who received ≥1 Absorb were pooled from the ABSORB II, III, and JAPAN randomized trials and from the single arm ABSORB EXTEND registry. The study composite primary endpoint was target lesion failure (TLF) at 1 year following Absorb BVS compared with a performance goal of 12.7%. Among 754 diabetic patients included in analysis (27.3% insulin treated), the 1-year TLF rate was 8.3% (upper 1-sided 95% confidence limit: 10.1%; p = 0.0001 vs. performance goal). Scaffold thrombosis (definite or probable) was observed in 2.3% of patients. Multivariable regression identified older age, insulin treatment, and smaller pre-procedure reference vessel diameter as significant independent predictors of 1-year TLF. The Absorb diabetic substudy suggests efficacy and safety of the Absorb BVS for treatment of patients with diabetes mellitus. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  14. Motor Testing at 1 Year Improves the Prediction of Motor and Mental Outcome at 2 Years after Perinatal Hypoxic-Ischaemic Encephalopathy

    ERIC Educational Resources Information Center

    van Schie, Petra Em; Becher, Jules G.; Dallmeijer, Annet J.; Barkhof, Frederik; van Weissenbruch, Mirjam M.; Vermeulen, R. Jeroen

    2010-01-01

    Aim: To investigate the predictive value of motor testing at 1 year for motor and mental outcome at 2 years after perinatal hypoxic-ischaemic encephalopathy (HIE) in term neonates. Method: Motor and mental outcome at 2 years was assessed with the Bayley Scales of Infant Development, 2nd edition (BSID-II) in 32 surviving children (20 males, 12…

  15. Predictors of outcome at 2 years of age after early intrauterine growth restriction.

    PubMed

    Torrance, H L; Bloemen, M C T; Mulder, E J H; Nikkels, P G J; Derks, J B; de Vries, L S; Visser, G H A

    2010-08-01

    To examine the relative importance of antenatal and perinatal variables on short- and long-term outcome of preterm growth restricted fetuses with umbilical artery (UA) Doppler abnormalities. This was a cohort study of 180 neonates with birth weight < 10(th) percentile, gestational age at delivery < 34 weeks and abnormal Doppler ultrasound examination of the UA. Various antenatal and perinatal variables were studied in relation to short- and long-term outcome. Neonatal and overall mortality (up to 2 years of age) were predicted by low gestational age at delivery. Neonatal mortality was additionally predicted by absent or reversed UA end-diastolic flow, while the presence of severe neonatal complications and placental villitis were additional predictors of both infant (between 28 days and 1 year of postnatal life) and overall mortality. Placental villitis was found to be the only predictor of necrotizing enterocolitis. Low gestational age at delivery, male sex, abnormal cardiotocography, absent or reversed UA end-diastolic flow and the HELLP syndrome predicted respiratory distress syndrome. Abnormal neurodevelopmental outcome at 2 years was predicted by low birth weight (< 2.3(rd) percentile), fetal acidosis (UA pH < 7.00), and placental villitis. Less advanced gestation at delivery remains an important predictor of short-term outcome in growth-restricted fetuses. In addition, the presence of placental villitis may aid neonatologists in the early identification of infants at increased risk of necrotizing enterocolitis, death and abnormal neurodevelopment at 2 years of age. Abnormal neurodevelopment was related to low weight and acidosis at birth, indicating that the severity of malnutrition and fetal acidosis affect long-term outcome.

  16. Analysis of Urban Forest Needs as Anthropogenic (CO2) Gas Absorbent in Semarang City

    NASA Astrophysics Data System (ADS)

    Febriani, Anisa Putri; Retnaningsih Soeprobowati, Tri; Maryono

    2018-02-01

    Green open space in cities in significant needs to maintenance environment quality. On of the critical function is to absorb increasing number of gas CO2. Therefore, developing urban forest in cities is very importance. The objective of the study is to determine the area of urban forest as CO2 gas anthropogenic absorb which is formed from fuel, diesel fuel, liquid petroleum gas. The study consists of (1) Analyzing the number of CO2 gas emission by calculating the needs of petroleum and gas based on the number of population, (2) Analyzing the power of gas absorption, (3) Measuring the air concentration of CO2 gas ambient based on daily traffic activities. This study shown that from year 2013 to year 2017, the increasing of urban forest is not so significant. For year 2013 the green open space in Semarang City are 373.67 hectares (7.5 percent from Semarang City area), consists of 239 parks, 11 public cemeteries, production forests, community forests, and urban forests, however the area of urban forest is not increase. The study assess that Antidesmabunius is one of the green species which high absorb capacity planted for Semarang. This trees produce 31,31 ton annually. This study proposed to fostering Antidesmabunius as one principle threes in Semarang urban forest.

  17. Do measures of surgical effectiveness at 1 year after lumbar spine surgery accurately predict 2-year outcomes?

    PubMed

    Adogwa, Owoicho; Elsamadicy, Aladine A; Han, Jing L; Cheng, Joseph; Karikari, Isaac; Bagley, Carlos A

    2016-12-01

    OBJECTIVE With the recent passage of the Patient Protection and Affordable Care Act, there has been a dramatic shift toward critical analyses of quality and longitudinal assessment of subjective and objective outcomes after lumbar spine surgery. Accordingly, the emergence and routine use of real-world institutional registries have been vital to the longitudinal assessment of quality. However, prospectively obtaining longitudinal outcomes for patients at 24 months after spine surgery remains a challenge. The aim of this study was to assess if 12-month measures of treatment effectiveness accurately predict long-term outcomes (24 months). METHODS A nationwide, multiinstitutional, prospective spine outcomes registry was used for this study. Enrollment criteria included available demographic, surgical, and clinical outcomes data. All patients had prospectively collected outcomes measures and a minimum 2-year follow-up. Patient-reported outcomes instruments (Oswestry Disability Index [ODI], SF-36, and visual analog scale [VAS]-back pain/leg pain) were completed before surgery and then at 3, 6, 12, and 24 months after surgery. The Health Transition Index of the SF-36 was used to determine the 1- and 2-year minimum clinically important difference (MCID), and logistic regression modeling was performed to determine if achieving MCID at 1 year adequately predicted improvement and achievement of MCID at 24 months. RESULTS The study group included 969 patients: 300 patients underwent anterior lumbar interbody fusion (ALIF), 606 patients underwent transforaminal lumbar interbody fusion (TLIF), and 63 patients underwent lateral interbody fusion (LLIF). There was a significant correlation between the 12- and 24-month ODI (r = 0.82; p < 0.0001), SF-36 Physical Component Summary score (r = 0.89; p < 0.0001), VAS-back pain (r = 0.90; p < 0.0001), and VAS-leg pain (r = 0.85; p < 0.0001). For the ALIF cohort, patients achieving MCID thresholds for ODI at 12 months were 13-fold (p < 0

  18. Different CO2 absorbents-modified SBA-15 sorbent for highly selective CO2 capture

    NASA Astrophysics Data System (ADS)

    Liu, Xiuwu; Zhai, Xinru; Liu, Dongyang; Sun, Yan

    2017-05-01

    Different CO2 absorbents-modified SBA-15 materials are used as CO2 sorbent to improve the selectivity of CH4/CO2 separation. The SBA-15 sorbents modified by physical CO2 absorbents are very limited to increasing CO2 adsorption and present poor selectivity. However, the SBA-15 sorbents modified by chemical CO2 absorbents increase CO2 adsorption capacity obviously. The separation coefficients of CO2/CH4 increase in this case. The adsorption and regeneration properties of the SBA-15 sorbents modified by TEA, MDEA and DIPA have been compared. The SBA-15 modified by triethanolamine (TEA) presents better CO2/CH4 separation performance than the materials modified by other CO2 absorbents.

  19. Neonatal Glycemia and Neurodevelopmental Outcomes at 2 Years.

    PubMed

    McKinlay, Christopher J D; Alsweiler, Jane M; Ansell, Judith M; Anstice, Nicola S; Chase, J Geoffrey; Gamble, Gregory D; Harris, Deborah L; Jacobs, Robert J; Jiang, Yannan; Paudel, Nabin; Signal, Matthew; Thompson, Benjamin; Wouldes, Trecia A; Yu, Tzu-Ying; Harding, Jane E

    2015-10-15

    Neonatal hypoglycemia is common and can cause neurologic impairment, but evidence supporting thresholds for intervention is limited. We performed a prospective cohort study involving 528 neonates with a gestational age of at least 35 weeks who were considered to be at risk for hypoglycemia; all were treated to maintain a blood glucose concentration of at least 47 mg per deciliter (2.6 mmol per liter). We intermittently measured blood glucose for up to 7 days. We continuously monitored interstitial glucose concentrations, which were masked to clinical staff. Assessment at 2 years included Bayley Scales of Infant Development III and tests of executive and visual function. Of 614 children, 528 were eligible, and 404 (77% of eligible children) were assessed; 216 children (53%) had neonatal hypoglycemia (blood glucose concentration, <47 mg per deciliter). Hypoglycemia, when treated to maintain a blood glucose concentration of at least 47 mg per deciliter, was not associated with an increased risk of the primary outcomes of neurosensory impairment (risk ratio, 0.95; 95% confidence interval [CI], 0.75 to 1.20; P=0.67) and processing difficulty, defined as an executive-function score or motion coherence threshold that was more than 1.5 SD from the mean (risk ratio, 0.92; 95% CI, 0.56 to 1.51; P=0.74). Risks were not increased among children with unrecognized hypoglycemia (a low interstitial glucose concentration only). The lowest blood glucose concentration, number of hypoglycemic episodes and events, and negative interstitial increment (area above the interstitial glucose concentration curve and below 47 mg per deciliter) also did not predict the outcome. In this cohort, neonatal hypoglycemia was not associated with an adverse neurologic outcome when treatment was provided to maintain a blood glucose concentration of at least 47 mg per deciliter. (Funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development and others.).

  20. Outcomes of Revision Hip Arthroscopy: 2-Year Clinical Follow-up.

    PubMed

    Gupta, Asheesh; Redmond, John M; Stake, Christine E; Dunne, Kevin F; Hammarstedt, Jon E; Domb, Benjamin G

    2016-05-01

    To evaluate clinical outcomes, pain, and patient satisfaction following revision hip arthroscopy with a minimum 2-year follow-up. From April 2008 to October 2011, data were prospectively collected on all patients undergoing revision hip arthroscopy. All patients were assessed pre- and postoperatively with 4 patient-reported outcome (PRO) measures: the modified Harris hip score (mHHS), nonarthritic hip score (NAHS), hip outcome score-activities of daily living (HOS-ADL), and hip outcome score-sport-specific subscales (HOS-SSS). Pain was estimated on the visual analog scale (VAS). Patient satisfaction was measured on a scale from 0 to 10. The number of patients who underwent subsequent revision arthroscopy or total hip arthroplasty during the study period is also reported. Eighty-seven patients underwent revision hip arthroscopy during the study period. Seventy (80.5%) patients were included in our study. Average follow-up time was 28 months (range, 20 to 47.4 months). In terms of residual femoroacetabular impingement morphology, 45.7% of patients had preoperative alpha angles ≥ 55°, and 7.14% of patients had a lateral center-edge angle ≥ 40°. The score improvement from preoperative to 2-year follow-up was 57.84 to 73.65 for mHHS, 62.79 to 83.04 for HOS-ADL, 37.33 to 54.93 for HOS-SSS, and 55.65 to 70.79 for NAHS. VAS decreased from 6.72 to 4.08. All scores demonstrated statistically significant improvement (P < .001). Overall patient satisfaction was 7.67. Our success rate was 74.58%. Ten (14.29%) patients underwent total hip arthroplasty during the study period. Our hip survivorship was 85.7%. Five (7.14%) patients underwent secondary revision hip arthroscopy during the study period. We found an overall minor complication rate of 10%. Revision hip arthroscopy for all procedures performed on aggregate has improved clinical outcomes for all PROs, high survivorship, and high patient satisfaction scores at short-term follow-up. Patients should be counseled

  1. Change in lumen eccentricity and asymmetry after treatment with Absorb bioresorbable vascular scaffolds in the ABSORB cohort B trial: a five-year serial optical coherence tomography imaging study.

    PubMed

    Suwannasom, Pannipa; Sotomi, Yohei; Asano, Taku; Koon, Jaryl Ng Chen; Tateishi, Hiroki; Zeng, Yaping; Tenekecioglu, Erhan; Wykrzykowska, Joanna J; Foin, Nicolas; de Winter, Robbert J; Ormiston, John A; Serruys, Patrick W; Onuma, Yoshinobu

    2017-04-07

    The aim of the study was to investigate long-term changes in lumen eccentricity and asymmetry at five years after implantation of the Absorb bioresorbable vascular scaffold (BVS). Out of 101 patients from the ABSORB cohort B trial, 28 patients (29 lesions) with serial optical coherence tomography (OCT) examination at four different time points (cohort B1: post-procedure, six months, two, and five years [n=13]; cohort B2: post-procedure, one, three, and five years [n=16]) were evaluated. The longitudinal variance in lumen diameter was assessed by asymmetry index (AI). An asymmetric lesion was defined as AI >0.3. The circularity of the lumen or scaffold was evaluated by the eccentricity index calculated as minimal divided by maximal luminal or scaffold diameter per cross-section. The lowest lumen eccentricity index within a scaffold segment (EIL) <0.7 was defined as an eccentric lesion. Post procedure, an eccentric lesion was observed in 72.4% and became concentric in 93.1% at five years (post EIL 0.67±0.05 vs. five-year EIL 0.80±0.10, p=0.03) with a modest reduction of the lumen area from baseline to five years by 0.75±0.32 mm2. Asymmetric lumen morphology was observed in 93.1% (n=27) post implantation and persisted until five-year follow-up. On serial OCT analyses, there was a substantial increase in the scaffold EI during the first two years (post 0.70±0.06, six months 0.76±0.08, two years 0.85±0.07); then, it remained stable whereas the lumen circularity improved further. There were no significant differences in major adverse cardiac events regarding the lumen morphology over the five-year follow-up. In patients treated with the Absorb BVS, the cross-sectional circularity improved over five years while the variance in longitudinal diameters remained. Regaining of lumen circularity is mainly caused by reshaping of the scaffold during the first two years.

  2. Borderline Personality Disorder Features in Nonclinical Young Adults: 2. Two-Year Outcome

    PubMed Central

    Trull, Timothy J.; Useda, J. David; Conforti, Kelly; Doan, Bao-Tran

    2013-01-01

    Borderline personality disorder (BPD) is thought to develop by early adulthood, and it is characterized by lack of control of anger, intense and frequent mood changes, impulsive acts, disturbed interpersonal relationships, and life-threatening behaviors. We describe data from a 2-year follow-up study of nonclinical young adults who, at study entry, exhibited a significant number of BPD features. Individuals with borderline features were more likely to have academic difficulties over the succeeding 2 years, and these participants were more likely to meet lifetime criteria for a mood disorder and to experience interpersonal dysfunction than their peers at the 2-year follow-up assessment. These findings indicate that BPD features are associated with poorer outcome even within a nonclinical population. PMID:9131850

  3. Neonatal Glycemia and Neurodevelopmental Outcomes at 2 Years

    PubMed Central

    McKinlay, Christopher J.D.; Alsweiler, Jane M.; Ansell, Judith M.; Anstice, Nicola S.; Chase, J. Geoffrey; Gamble, Gregory D.; Harris, Deborah L.; Jacobs, Robert J.; Jiang, Yannan; Paudel, Nabin; Signal, Matthew; Thompson, Benjamin; Wouldes, Trecia A.; Yu, Tzu-Ying; Harding, Jane E.

    2015-01-01

    Background Neonatal hypoglycemia is common and can cause neurologic impairment, but evidence supporting thresholds for intervention is limited. Methods We performed a prospective cohort study involving 528 neonates with a gestational age of at least 35 weeks who were considered to be at risk for hypoglycemia; all were treated to maintain a blood glucose concentration of at least 47 mg per deciliter (2.6 mmol per liter). We intermittently measured blood glucose for up to 7 days. We continuously monitored interstitial glucose concentrations, which were masked to clinical staff. Assessment at 2 years included Bayley Scales of Infant Development III and tests of executive and visual function. Results Of 614 children, 528 were eligible, and 404 (77% of eligible children) were assessed; 216 children (53%) had neonatal hypoglycemia (blood glucose concentration, <47 mg per deciliter). Hypoglycemia, when treated to maintain a blood glucose concentration of at least 47 mg per deciliter, was not associated with an increased risk of the primary outcomes of neurosensory impairment (risk ratio, 0.95; 95% confidence interval [CI], 0.75 to 1.20; P = 0.67) and processing difficulty, defined as an executive-function score or motion coherence threshold that was more than 1.5 SD from the mean (risk ratio, 0.92; 95% CI, 0.56 to 1.51; P = 0.74). Risks were not increased among children with unrecognized hypoglycemia (a low interstitial glucose concentration only). The lowest blood glucose concentration, number of hypoglycemic episodes and events, and negative interstitial increment (area above the interstitial glucose concentration curve and below 47 mg per deciliter) also did not predict the outcome. Conclusions In this cohort, neonatal hypoglycemia was not associated with an adverse neurologic outcome when treatment was provided to maintain a blood glucose concentration of at least 47 mg per deciliter. (Funded by the Eunice Kennedy Shriver National Institute of Child Health and Human

  4. Bilateral Forearm Transplantation in Mexico: 2-Year Outcomes.

    PubMed

    Iglesias, Martin; Butron, Patricia; Moran-Romero, Mario; Cruz-Reyes, Angel; Alberu-Gomez, Josefina; Leal-Villalpando, Paulino; Bautista-Zamudio, Jorge; Ramirez-Berumen, Maria; Lara-Hinojosa, Euridice; Espinosa-Cruz, Veronica; Gaytan-Cervantes, Rocio; Bravo-Ruiz, Leonardo; Rodriguez-Rojas, Elizabeth; Ramos-Peek, Jaime; Garcia-Alvarez, Miriam; Vega-Boada, Felipe; Sierra-Madero, Juan; Gamboa-Dominguez, Armando; Gonzalez-Sanchez, Judith; Contreras-Barbosa, Sarai; Navarro-Lara, Africa; Vazquez-Lamadrid, Jorge; Guzman-Gonzalez, Juan

    2016-01-01

    Patients with proximal forearm and arm transplantation have obtained and/or maintained function of the elbow joint and full active range of motion of the extrinsic muscles of the hand, but with diminished protective sensibility and a lack of good function of the intrinsic muscles. These patients have improved function, as measured by the Disabilities of the Arm, Shoulder and Hand questionnaire. We report the case of a 52-year-old man who suffered a high-voltage electrical burn requiring amputation of his upper limbs. He underwent bilateral proximal forearm transplantation in Mexico City in May 2012. At 2-year follow-up, immunosuppressive treatment has not led to metabolic, oncologic, or infectious complications. Keloid scars developed at the graft-recipient interface. There have been 4 acute rejections: the fourth was treated with methylprednisolone, rituximab, and immunoglobulin. Chronic rejection has not been detected. The extrinsic muscles of the wrist and digits have good function. Although the intrinsic muscles demonstrated electrical activity 15 months postoperatively, clinically, they are nonuseful. After 2 years, hand function is sufficient to allow the patient to grasp lightweight and medium-sized objects. The patient's Disabilities of the Arm, Shoulder and Hand questionnaire score improved from 50.00 points to 30.83 points, and his Hand Transplantation Score System rating is good, at 69/73 (right/left) of 100. The patient and his family are very satisfied with the functional and aesthetic outcomes. Upper arm or proximal forearm transplantation is a reconstructive option for patients who have experienced amputation because of trauma.

  5. Esthetic outcome and alterations of soft tissue around single implant crowns: a 2-year prospective study.

    PubMed

    Gu, Ying-Xin; Shi, Jun-Yu; Zhuang, Long-Fei; Qiao, Shi-Chong; Xu, You-You; Lai, Hong-Chang

    2015-08-01

    The aim of this prospective study was to assess the esthetic outcome and alterations of peri-implant soft tissue using tissue-level implants. Furthermore, the influencing factors, including grafting and gingival biotype, of esthetic outcome of peri-implant soft tissue were also evaluated. Of 38 patients with single missing anterior tooth in maxilla were treated with a Straumann (®) Standard Plus SLA implant. Bone augmentation was performed in 24 patients. Follow-up was conducted at 12 and 24 months after definitive crowns placement. Esthetic outcome using the pink esthetic score/white esthetic score (PES/WES) and clinical parameters were evaluated. The mean PES/WES value at baseline, 1-year, and 2-year examination was 13.79, 14.87, and 14.96. Significant improvement was found between baseline and 1-year examination (P < 0.01). And the improvement between 1-year and 2-year examination was not significant (P = 0.40). The mean PES changing value in patients with thick biotype was significantly higher than those with thin biotype at 2-year after definitive crowns placement (P = 0.03). Graft procedure had an unfavorable effect on mean PES value both at baseline and at follow-up (P < 0.01). No implants were lost at 2-year examination. Three patients experienced peri-implant infection. No significant difference was found with the passage of time in modified plaque index (mPI), probing pocket depth (PPD), and modified bleeding index (mBI). According to the present prospective clinical study, it can be concluded that it is feasible to use tissue-level implant to support single crowns in esthetic area. Favorable short-term esthetic outcome and stability of soft tissue around single implant crowns can be expected in patients with or without graft. However, graft procedures might have an unfavorable effect on the esthetic outcome. Gingival biotype can be considered as prognostic factor for esthetic outcome. RCTs with long-term follow-up are needed to provide evidence for the

  6. Children who screen positive for autism at 2.5 years and receive early intervention: a prospective naturalistic 2-year outcome study

    PubMed Central

    Spjut Jansson, Birgitta; Miniscalco, Carmela; Westerlund, Joakim; Kantzer, Anne-Katrin; Fernell, Elisabeth; Gillberg, Christopher

    2016-01-01

    Background Previous research has stressed the importance of early identification and intervention for children with autism spectrum disorders. Methods Children who had screened positive for autism at the age of 2.5 years in a general population screening and then received a diagnosis of autism spectrum disorder were enrolled in an intervention program provided by Swedish habilitation services. The following interventions were available: a comprehensive intervention based on Applied Behavior Analysis – Intensive Learning (IL) – in two settings, which included home- and preschool-based (IL Regular) and only home-based (IL Modified) and eclectic interventions. Results There was considerable variability in terms of outcome, but intervention group status was not associated with any of the chosen outcome variables. Conclusion The main finding was that the type of intervention was not critical for outcome of adaptive or global functioning. The variability in outcome demonstrates the need for continuous assessments and evaluation of the child’s function and behavior throughout the intervention period. PMID:27621636

  7. Leg pain and psychological variables predict outcome 2-3 years after lumbar fusion surgery.

    PubMed

    Abbott, Allan D; Tyni-Lenné, Raija; Hedlund, Rune

    2011-10-01

    Prediction studies testing a thorough range of psychological variables in addition to demographic, work-related and clinical variables are lacking in lumbar fusion surgery research. This prospective cohort study aimed at examining predictions of functional disability, back pain and health-related quality of life (HRQOL) 2-3 years after lumbar fusion by regressing nonlinear relations in a multivariate predictive model of pre-surgical variables. Before and 2-3 years after lumbar fusion surgery, patients completed measures investigating demographics, work-related variables, clinical variables, functional self-efficacy, outcome expectancy, fear of movement/(re)injury, mental health and pain coping. Categorical regression with optimal scaling transformation, elastic net regularization and bootstrapping were used to investigate predictor variables and address predictive model validity. The most parsimonious and stable subset of pre-surgical predictor variables explained 41.6, 36.0 and 25.6% of the variance in functional disability, back pain intensity and HRQOL 2-3 years after lumbar fusion. Pre-surgical control over pain significantly predicted functional disability and HRQOL. Pre-surgical catastrophizing and leg pain intensity significantly predicted functional disability and back pain while the pre-surgical straight leg raise significantly predicted back pain. Post-operative psychomotor therapy also significantly predicted functional disability while pre-surgical outcome expectations significantly predicted HRQOL. For the median dichotomised classification of functional disability, back pain intensity and HRQOL levels 2-3 years post-surgery, the discriminative ability of the prediction models was of good quality. The results demonstrate the importance of pre-surgical psychological factors, leg pain intensity, straight leg raise and post-operative psychomotor therapy in the predictions of functional disability, back pain and HRQOL-related outcomes.

  8. Intrascleral outflow after deep sclerectomy with absorbable and non-absorbable implants in the rabbit eye.

    PubMed

    Kałużny, Jakub J; Grzanka, Dariusz; Wiśniewska, Halina; Niewińska, Alicja; Kałużny, Bartłomiej J; Grzanka, Alina

    2012-10-01

    The purpose of the study is an analysis of intrascleral drainage vessels formed in rabbits' eyes after non-penetrating deep sclerectomy (NPDS) with absorbable and non-absorbable implants, and comparison to eyes in which surgery was performed without implanted material. NPDS was carried out in 12 rabbits, with implantation of non-absorbable methacrylic hydrogel (N=10 eyes) or absorbable cross-linked sodium hyaluronate (N=6 eyes), or without any implant (N=8 eyes). All the animals were euthanized 1 year after surgery. Twenty-one eyeballs were prepared for light microscopy and 3 were prepared for transmission electron microscope (TEM) analysis. Aqueous humour pathways were stained with ferritin in 6 eyeballs. By light microscopy, small vessels adjacent to the areas of scarring were the most common abnormality. Vessel density was significantly higher in operated sclera compared to normal, healthy tissue, regardless of the type of implant used. The average vessel densities were 2.18±1.48 vessels/mm2 in non-implanted sclera, 2.34±1.69 vessels/mm2 in eyes with absorbable implants, and 3.64±1.78 vessels/mm2 in eyes with non-absorbable implants. Analysis of iron distribution in ferritin-injected eyes showed a positive reaction inside new aqueous draining vessels in all groups. TEM analysis showed that the ultrastructure of new vessels matched the features of the small veins. Aqueous outflow after NPDS can be achieved through the newly formed network of small intrascleral veins. Use of non-absorbable implants significantly increases vessel density in the sclera adjacent to implanted material compared to eyes in which absorbable implants or no implants were used.

  9. Outcome of forceps delivery in a teaching hospital: A 2 year experience

    PubMed Central

    John, Lopamudra B.; Nischintha, S.; Ghose, Seetesh

    2014-01-01

    Introduction: The art of forceps delivery though existing for centuries has earned a disreputation due to the possibility of poor maternal and fetal outcome. However, its safe use can reduce the rising cesarean section rates in the present times. This study is to see the outcome of its use in a teaching hospital over a 2 year period. Materials and Methods: In this retrospective observational study, 120 cases of forceps delivery were studied for maternal outcome such as injuries, postpartum hemorrhage, and fetal outcome such as Apgar score at birth, neonatal intensive care unit admissions, injury, and mortality. Results: The most common indication was fetal distress (47.5%). A total of 15 cases (12.5%) of maternal injuries occurred, with 2 uterine ruptures one of which was in a previous lower segment caesarean section case, 4 complete perineal tears and 9 minor cervical and vaginal lacerations. A total of 12 babies (10%) had poor Apgar scores who recovered after resuscitation and one out of them died, which was a case of multiple instrumentation. Conclusion: Forceps is a reasonable option for the obstetrician to reduce the caesarean section rates; however, extreme caution, proper expertise and judicial use of this instrument are required to prevent undue risk to mother and fetus. PMID:24678216

  10. Revision versus primary arthroscopic rotator cuff repair: a 2-year analysis of outcomes in 360 patients.

    PubMed

    Shamsudin, Aminudin; Lam, Patrick H; Peters, Karin; Rubenis, Imants; Hackett, Lisa; Murrell, George A C

    2015-03-01

    Symptomatic rotator cuff tears are often treated surgically. However, there is a paucity of information regarding the outcomes of revision arthroscopic rotator cuff repairs. To evaluate the outcome of revision arthroscopic rotator cuff surgery when compared with primary arthroscopic rotator cuff surgery in a large cohort of patients. Cohort study; Level of evidence, 3. A consecutive series of 50 revision arthroscopic rotator cuff repairs performed by a single surgeon, with minimum 2-year follow-up, were retrospectively reviewed using prospectively collected data. As a comparison, 3 primary arthroscopic rotator cuff repair cases (primary group; n = 310) were chosen immediately before each revision case, and 3 were chosen after. Standardized patient-ranked outcomes, examiner-determined assessments, and ultrasound-determined rotator cuff integrity were assessed preoperatively at 6 months and at a minimum of 2 years after surgery. The revision group was older (mean age, 63 years; range, 43-80 years) compared with the primary group (mean age, 60 years; range, 18-88 years) (P < .05) and had larger tear size (mean ± SEM) (4.1 ± 0.5 cm(2)) compared with the primary group (3.0 ± 0.2 cm(2)) (P < .05). Two years after surgery, the primary group reported less pain at rest (P < .02), during sleep (P < .05), and with overhead activity (P < .01) compared with the revision group. The primary group had better passive forward flexion (+13°; P < .05), abduction (+18°; P < .01), internal rotation (+2 vertebral levels; P < .001) and also significantly greater supraspinatus strength (+15 N; P < .001), lift-off strength (+9.3 N; P < .05), and adduction strength (+20 N; P < .01) compared with the revision group at 2 years. When compared with the primary group, the revision group was more satisfied with the overall shoulder function before surgery but was less satisfied with their shoulder function than the primary group at 2 years (P < .005). The retear rate for primary rotator cuff

  11. Physical Therapy Protocol After Hip Arthroscopy: Clinical Guidelines Supported by 2-Year Outcomes.

    PubMed

    Domb, Benjamin G; Sgroi, Terrance A; VanDevender, Jeremy C

    2016-07-01

    Femoroacetabular impingement (FAI) was first described by Ganz in 2003 and is a significant cause of decreased function and mobility. Femoroacetabular impingement must be treated in an individualized, goal-oriented, stepwise fashion. This protocol was developed with biomechanical considerations of soft tissue and bony structures surrounding the hip joint. The PubMed database was searched for scientific and review articles from the years 2000 to 2015 utilizing the search terms: hip rehabilitation, femoroacetabular impingement, and arthroscopy. Clinical review. Level 5. Five hundred ninety-five of 738 patients were available for follow-up showing improvement from preoperative to 2-year follow-up of 61.29 to 82.02 for modified Harris Hip Score (mHHS), 62.79 to 83.04 for Hip Outcome Score-Activities of Daily Living (HOS-ADL), 40.96 to 70.07 for Hip Outcome Score-Sport-Specific Subscale (HOS-SSS), and 57.97 to 80.41 for Non-Arthritic Hip Score (NAHS); visual analog scale (VAS) scores decreased from 5.86 preoperatively to 2.94 postoperatively. Following a structured, criteria-based program, appropriate patients undergoing hip arthroscopy may achieve excellent outcomes and return to full independent activities of daily living as well as sport. © 2016 The Author(s).

  12. Early Postoperative Measures Predict 1- and 2-Year Outcomes After Unilateral Total Knee Arthroplasty: Importance of Contralateral Limb Strength

    PubMed Central

    Snyder-Mackler, Lynn

    2010-01-01

    Background Total knee arthroplasty (TKA) has been shown to be an effective surgical intervention for people with end-stage knee osteoarthritis. However, recovery of function is variable, and not all people have successful outcomes. Objective The aim of this study was to discern which early postoperative functional measures could predict functional ability at 1 year and 2 years after surgery. Design and Methods One hundred fifty-five people who underwent unilateral TKA participated in the prospective longitudinal study. Functional evaluations were performed at the initial outpatient physical therapy appointment and at 1 and 2 years after surgery. Evaluations consisted of measurements of height, weight, quadriceps muscle strength (force-generating capacity), and knee range of motion; the Timed “Up & Go” Test (TUG); the stair-climbing task (SCT); and the Knee Outcome Survey (KOS) questionnaire. The ability to predict 1- and 2-year outcomes on the basis of early postoperative measures was analyzed with a hierarchical regression. Differences in functional scores were evaluated with a repeated-measures analysis of variance. Results The TUG, SCT, and KOS scores at 1 and 2 years showed significant improvements over the scores at the initial evaluation (P<.001). A weaker quadriceps muscle in the limb that did not undergo surgery (“nonoperated limb”) was related to poorer 1- and 2-year outcomes even after the influence of the other early postoperative measures was accounted for in the regression. Older participants with higher body masses also had poorer outcomes at 1 and 2 years. Postoperative measures were better predictors of TUG and SCT times than of KOS scores. Conclusions Rehabilitation regimens after TKA should include exercises to improve the strength of the nonoperated limb as well as to treat the deficits imposed by the surgery. Emphasis on treating age-related impairments and reducing body mass also might improve long-term outcomes. PMID:19959653

  13. Specific impact of stimulant, alcohol and cannabis use disorders on first-episode psychosis: 2-year functional and symptomatic outcomes.

    PubMed

    Ouellet-Plamondon, C; Abdel-Baki, A; Salvat, É; Potvin, S

    2017-10-01

    Many studies have concluded that cannabis use disorder (CUD) negatively influences outcomes in first-episode psychosis (FEP). However, few have taken into account the impact of concurrent misuse of other substances. This 2-year, prospective, longitudinal study of FEP patients, aged between 18 and 30 years, admitted to early intervention programs in Montreal, Quebec, Canada, examined the specific influence of different substance use disorders (SUD) (alcohol, cannabis, cocaine, amphetamines) on service utilization, symptomatic and functional outcomes in FEP. Drugs and alcohol were associated with lower functioning, but drugs had a greater negative impact on most measures at 2-year follow-up. Half of CUD patients and more than 65% of cocaine or amphetamine abusers presented polysubstance use disorder (poly-SUD). The only group that deteriorated from years 1 to 2 (symptoms and functioning) were patients with persistent CUD alone. Outcome was worse in CUD than in the no-SUD group at 2 years. Cocaine, amphetamines and poly-SUD were associated with worse symptomatic and functional outcomes from the 1st year of treatment, persisting over time with higher service utilization (hospitalization). The negative impact attributed to CUD in previous studies could be partly attributed to methodological flaws, like including polysubstance abusers among cannabis misusers. However, our investigation confirmed the negative effect of CUD on outcome. Attention should be paid to persistent cannabis misusers, since their condition seems to worsen over time, and to cocaine and amphetamine misusers, in view of their poorer outcome early during follow-up and high service utilization.

  14. Insight into unusual impurity absorbability of GeO(2) in GeO(2)∕Ge stacks.

    PubMed

    Ogawa, Shingo; Suda, Taichi; Yamamoto, Takashi; Kutsuki, Katsuhiro; Hideshima, Iori; Hosoi, Takuji; Shimura, Takayoshi; Watanabe, Heiji

    2011-10-03

    Adsorbed species and its diffusion behaviors in GeO(2)∕Ge stacks, which are future alternative metal-oxide-semiconductor (MOS) materials, have been investigated using various physical analyses. We clarified that GeO(2) rapidly absorbs moisture in air just after its exposure. After the absorbed moisture in GeO(2) reaches a certain limit, the GeO(2) starts to absorb some organic molecules, which is accompanied by a structural change in GeO(2) to form a partial carbonate or hydroxide. We also found that the hydrogen distribution in GeO(2) shows intrinsic characteristics, indicative of different diffusion behaviors at the surface and at the GeO(2)∕Ge interface. Because the impurity absorbability of GeO(2) has a great influence on the electrical properties in Ge-MOS devices, these results provide valuable information in realizing high quality GeO(2)∕Ge stacks for the actual use of Ge-MOS technologies.

  15. Advanced EMU electrochemically regenerable CO2 and moisture absorber module breadboard

    NASA Technical Reports Server (NTRS)

    Lee, M. C.; Sudar, M.; Chang, B. J.

    1988-01-01

    The applicability of the Electrochemically Regenerable Carbon Dioxide and Moisture Absorption Technology to the advanced extravehicular mobility unit was demonstrated by designing, fabricating, and testing a breadboard Absorber Module and an Electrochemical Regenerator. Test results indicated that the absorber module meets or exceeds the carbon dioxide removal requirements specified for the design and can meet the moisture removal requirement when proper cooling is provided. CO2 concentration in the vent gas stream was reduced from 0.52 to 0.027 kPa (3.9 to 0.20 mm Hg) for the full five hour test period. Vent gas dew point was reduced from inlet values of 294 K (69 F) to 278 K (41 F) at the outlet. The regeneration of expended absorbent was achieved by the electrochemical method employed in the testing. An absorbent bed using microporous hydrophobic membrane sheets with circulating absorbent is shown to be the best approach to the design of an Absorber Module based on sizing and performance. Absorber Module safety design, comparison of various absorbents and their characteristics, moisture absorption and cooling study and subsystem design and operation time-lining study were also performed.

  16. Fetal and Postnatal Head Circumference Growth: Synergetic Factors for Neurodevelopmental Outcome at 2 Years of Age for Preterm Infants.

    PubMed

    Sicard, Mélanie; Nusinovici, Simon; Hanf, Matthieu; Muller, Jean-Baptiste; Guellec, Isabelle; Ancel, Pierre-Yves; Gascoin, Géraldine; Rozé, Jean-Christophe; Flamant, Cyril

    2017-01-01

    Preterm infants present higher risk of non-optimal neurodevelopmental outcome. Fetal and postnatal growth, in particular head circumference (HC), is associated with neurodevelopmental outcome. We aimed to calculate the relationship between HC at birth, HC delta Z-score (between birth and hospital discharge), and non-optimal neurodevelopmental outcome at 2 years of corrected age in preterm infants. Surviving infants born ≤34 weeks of gestation were included in the analysis. The relationship between the risk of being non-optimal at 2 years and both HC at birth and HC growth was assessed. The 2 Z-scores were considered first independently and then simultaneously to investigate their effect on the risk of non-optimality using a generalized additive model. A total of 4,046 infants with both HC measures at birth and hospital discharge were included. Infants with small HC at birth (Z-score <-2 SD), or presenting suboptimal HC growth (dZ-score <-2 SD), are at higher risk of non-optimal neurodevelopmental outcome at 2 years (respectively OR 1.7 [95% CI 1.4-2] and OR 1.4 [95% CI 1.2-1.8]). Interestingly, patients cumulating small HC Z-score at birth (-2 SD) and presenting catch-down growth (HC dZ-score [-2 SD]) have a significantly increased risk for neurocognitive impairment (OR >2) while adjusting for gestational age, twin status, sex, and socioeconomic information. HC at birth and HC dZ-score between birth and hospital discharge are synergistically associated to neurodevelopmental outcome at 2 years of corrected age, in a population-based prospective cohort of preterm infants born ≤34 weeks of gestation. © 2017 S. Karger AG, Basel.

  17. Improving CO2 permeation and separation performance of CO2-philic polymer membrane by blending CO2 absorbents

    NASA Astrophysics Data System (ADS)

    Cheng, Jun; Hu, Leiqing; Li, Yannan; Liu, Jianzhong; Zhou, Junhu; Cen, Kefa

    2017-07-01

    To research effects of CO2 absorption capacity and type of CO2 absorbent on the CO2 separation and free-volume properties of facilitated transport membranes, two types of CO2 absorbents, namely monoethanolamine (MEA) and ionic liquids (ILs:[P66614][Triz] and [P66614][2-Op]), were adopted. The CO2 absorption capacities of MEA, [P66614][Triz] and [P66614][2-Op] were about 0.561 mol CO2 per mol, 0.95 mol CO2 per mol and 1.60 mol CO2 per mol, respectively. All mean free-volume hole radiuses of membranes decreased after blending CO2 absorbents. After polymer membrane blended with two ILs, number of free-volume hole increased, resulting in modest increase of the fractional free volume. Both CO2 permeability and selectivity increased after blending MEA and ILs. The increasing range of CO2 permeability corresponded with CO2 absorption capacity of CO2 absorbents, and membrane blending with [P66614][2-Op] showed the highest CO2 permeability of 672.1 Barrers at 25 °C. Pebax/PEGDME membrane blending with MEA obtained the highest CO2/H2 and CO2/CH4 selectivity at 17.8 and 20.5, respectively.

  18. In vitro performance of prefilled CO2 absorbers with the Zeus®.

    PubMed

    Omer, Mohab; Hendrickx, Jan F A; De Ridder, Simon; De Houwer, Alexander; Carette, Rik; De Cooman, Sofie; De Wolf, Andre M

    2017-12-13

    Low fresh gas flows (FGFs) decrease the use of anesthetic gases, but increase CO 2 absorbent usage. CO 2 absorbent usage remains poorly quantified. The goal of this study is to determine canister life of 8 commercially available CO 2 absorbent prepacks with the Zeus ® . Pre-packed CO 2 canisters of 8 different brands were tested in vitro: Amsorb Plus, Spherasorb, LoFloSorb, LithoLyme, SpiraLith, SpheraSorb, Drägersorb 800+, Drägersorb Free, and CO2ntrol. CO 2 (160 mL min - 1 ) flowed into the tip of a 2 L breathing bag that was ventilated with a tidal volume of 500 mL, a respiratory rate of 10/min, and an I:E ratio of 1:1 using the controlled mechanical ventilation mode of the Zeus ® (Dräger, Lubeck, Germany). In part I, canister life of 5 canisters each of 2 different lots of each brand was determined with a 350 mL min - 1 FGF. Canister life is the time it takes for the inspired CO 2 concentration (F I CO 2 ) to rise to 0.5%. In part II, canister life was measured accross a FGF range of 0.25 to 4 L min - 1 for Drägersorb 800+ (2 lots) and SpiraLith (1 lot). In part III, the calculated canister life per 100 g fresh granule content of the different brands was compared between the Zeus and (previously published data for) the Aisys. In vitro canister life of prefilled CO 2 absorber canisters differed between brands, and depended on the amount of CO 2 absorbent and chemical composition. Canister life expressed as FCU 0.5 (the fraction of the canister used per hour) was proportional to FGF over 0.2-2 L min -1 range only, but was non-linear with higher FGF: FCU 0.5 was larger than expected with FGF > 2 L min -1 , and even with FGF > minute ventilation FCU 0.5 did not become zero, indicating some CO 2 was being absorbed. Canister life on a per weight basis of the same brand is higher with the Zeus than the Aisys. Canister life of prefilled CO 2 absorber canisters differs between brands. The FCU 0.5 -FGF relationship is not linear across

  19. Cosmetic outcomes of facial lacerations repaired with tissue-adhesive, absorbable, and nonabsorbable sutures.

    PubMed

    Holger, Joel S; Wandersee, Steve C; Hale, David B

    2004-07-01

    The objective of this study was to compare the 9- to 12-month cosmetic outcome of facial lacerations closed with rapid-absorbing gut suture (RG), octylcyanoacrylate (OC), or nylon suture (NL). We hypothesized that no important differences would exist between these methods. This prospective, randomized study enrolled consecutive patients with facial lacerations when experienced physician assistants were on duty for wound closure. Patients returned at 9 to 12 months for cosmetic evaluation. Two blinded physicians performed visual analog cosmesis scale (VACS) scoring, and the patient completed a VAS satisfaction score. One hundred forty-five patients were enrolled. Nine-month follow up occurred in 84 patients. The maximum difference within each evaluator's set of scores was 3.6 mm, well below the minimum clinically important difference (MCID) of 10 to 15 mm. We did not detect clinically important differences in cosmetic outcome at 9 to 12 months in patients with facial lacerations closed with RG, OC, or NL, although RG or OC could be preferred to eliminate follow-up visits for suture removal.

  20. Broadband planar multilayered absorbers tuned by VO2 phase transition

    NASA Astrophysics Data System (ADS)

    Peng, Hao; Ji, Chunhui; Lu, Lulu; Li, Zhe; Li, Haoyang; Wang, Jun; Wu, Zhiming; Jiang, Yadong; Xu, Jimmy; Liu, Zhijun

    2017-08-01

    The metal-insulator transition makes vanadium dioxide an attractive material for developing reconfigurable optoelectronic components. Here we report on dynamically tunable broadband absorbers consisting of planar multilayered thin films. By thermally triggering the phase transition of vanadium dioxide, the effective impedance of multilayered structures is tuned in or out of the condition of impedance matching to free-space, leading to switchable broadband absorptions. Two types of absorbers are designed and demonstrated by using either the insulating or metallic state of vanadium dioxide at the impedance matched condition. The planar multilayered absorbers exhibit tunable absorption bands over the wavelength ranges of 5-9.3 μm and 3.9-8.2 μm, respectively. A large modulation depth up to 88% is measured. The demonstrated broadband absorbance tunability is of potential interest for reconfigurable bolometric sensing, camouflaging, and modulation of mid-infrared lights.

  1. Influence of the concentration of CO2 and SO2 on the absorption of CO2 by a lithium orthosilicate-based absorbent.

    PubMed

    Pacciani, R; Torres, J; Solsona, P; Coe, C; Quinn, R; Hufton, J; Golden, T; Vega, L F

    2011-08-15

    A novel, high temperature solid absorbent based on lithium orthosilicate (Li(4)SiO(4)) has shown promise for postcombustion CO(2) capture. Previous studies utilizing a clean, synthetic flue gas have shown that the absorbent has a high CO(2) capacity, >25 wt %, along with high absorption rates, lower heat of absorption and lower regeneration temperature than other solids such as calcium oxide. The current effort was aimed at evaluating the Li(4)SiO(4) based absorbent in the presence of contaminants found in typical flue gas, specifically SO(2), by cyclic exposure to gas mixtures containing CO(2), H(2)O (up to 25 vol. %), and SO(2) (up to 0.95 vol. %). In the absence of SO(2), a stable CO(2) capacity of ∼ 25 wt % over 25 cycles at 550 °C was achieved. The presence of SO(2), even at concentrations as low as 0.002 vol. %, resulted in an irreversible reaction with the absorbent and a decrease in CO(2) capacity. Analysis of SO(2)-exposed samples revealed that the absorbent reacted chemically and irreversibly with SO(2) at 550 °C forming Li(2)SO(4). Thus, industrial application would require desulfurization of flue gas prior to contacting the absorbent. Reactivity with SO(2) is not unique to the lithium orthosilicate material, so similar steps would be required for other absorbents that chemically react with SO(2).

  2. Kinetic analysis of an anion exchange absorbent for CO2 capture from ambient air.

    PubMed

    Shi, Xiaoyang; Li, Qibin; Wang, Tao; Lackner, Klaus S

    2017-01-01

    This study reports a preparation method of a new moisture swing sorbent for CO2 capture from air. The new sorbent components include ion exchange resin (IER) and polyvinyl chloride (PVC) as a binder. The IER can absorb CO2 when surrounding is dry and release CO2 when surrounding is wet. The manuscript presents the studies of membrane structure, kinetic model of absorption process, performance of desorption process and the diffusivity of water molecules in the CO2 absorbent. It has been proved that the kinetic performance of CO2 absorption/desorption can be improved by using thin binder and hot water treatment. The fast kinetics of P-100-90C absorbent is due to the thin PVC binder, and high diffusion rate of H2O molecules in the sample. The impressive is this new CO2 absorbent has the fastest CO2 absorption rate among all absorbents which have been reported by other up-to-date literatures.

  3. Kinetic analysis of an anion exchange absorbent for CO2 capture from ambient air

    PubMed Central

    Shi, Xiaoyang; Li, Qibin; Lackner, Klaus S.

    2017-01-01

    This study reports a preparation method of a new moisture swing sorbent for CO2 capture from air. The new sorbent components include ion exchange resin (IER) and polyvinyl chloride (PVC) as a binder. The IER can absorb CO2 when surrounding is dry and release CO2 when surrounding is wet. The manuscript presents the studies of membrane structure, kinetic model of absorption process, performance of desorption process and the diffusivity of water molecules in the CO2 absorbent. It has been proved that the kinetic performance of CO2 absorption/desorption can be improved by using thin binder and hot water treatment. The fast kinetics of P-100-90C absorbent is due to the thin PVC binder, and high diffusion rate of H2O molecules in the sample. The impressive is this new CO2 absorbent has the fastest CO2 absorption rate among all absorbents which have been reported by other up-to-date literatures. PMID:28640914

  4. Memory outcome 2 years after anterior temporal lobectomy in patients with drug-resistant epilepsy.

    PubMed

    Grammaldo, Liliana G; Di Gennaro, Giancarlo; Giampà, Teresa; De Risi, Marco; Meldolesi, Giulio N; Mascia, Addolorata; Sparano, Antonio; Esposito, Vincenzo; Quarato, Pier Paolo; Picardi, Angelo

    2009-03-01

    Memory decline is often observed after anterior temporal lobectomy (ATL), particularly in patients with dominant hemisphere resections. However, the follow-up length has been 1 year or less in most studies. Our aims were to examine postoperative memory changes over a longer period and to identify baseline demographic and clinical predictors of memory outcome. We administered material-specific memory tests at baseline, and 1 and 2 years after surgery to 82 consecutive right-handed patients (52% males) who underwent ATL for drug-resistant temporal lobe epilepsy (TLE) (35 left, 47 right) after a non-invasive presurgical protocol. Repeated measures multivariate analysis of variance (RM-MANOVA) was used to examine the relationship between changes in memory tests scores over time and side of TLE and pathology. Also, standardized residual change scores were calculated for each memory test and entered in multiple linear regression models aimed at identifying baseline predictors of better memory outcome. RM-MANOVA revealed a significant change in memory test scores over time, with an interaction between time and side of surgery, as 2 years after surgery patients with RTLE were improved while patients with LTLE were not worse as compared with baseline. Pathology was not associated with changes in memory scores. In multiple regression analysis, significant associations were found between right TLE and greater improvement in verbal memory, younger age and greater improvement in visuospatial memory, and male gender and greater improvement in both verbal and visuospatial memory. Our results suggest that the long-term memory outcome of TLE patients undergoing ATL without invasive presurgical assessment may be good in most cases not only for right-sided but also for left-sided resections.

  5. Thermal tuning of infrared resonant absorbers based on hybrid gold-VO{sub 2} nanostructures

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Kocer, Hasan; Department of Electrical Engineering, Turkish Military Academy, 06654 Ankara; Butun, Serkan

    2015-04-20

    Resonant absorbers based on plasmonic materials, metamaterials, and thin films enable spectrally selective absorption filters, where absorption is maximized at the resonance wavelength. By controlling the geometrical parameters of nano/microstructures and materials' refractive indices, resonant absorbers are designed to operate at wide range of wavelengths for applications including absorption filters, thermal emitters, thermophotovoltaic devices, and sensors. However, once resonant absorbers are fabricated, it is rather challenging to control and tune the spectral absorption response. Here, we propose and demonstrate thermally tunable infrared resonant absorbers using hybrid gold-vanadium dioxide (VO{sub 2}) nanostructure arrays. Absorption intensity is tuned from 90% to 20%more » and 96% to 32% using hybrid gold-VO{sub 2} nanowire and nanodisc arrays, respectively, by heating up the absorbers above the phase transition temperature of VO{sub 2} (68 °C). Phase change materials such as VO{sub 2} deliver useful means of altering optical properties as a function of temperature. Absorbers with tunable spectral response can find applications in sensor and detector applications, in which external stimulus such as heat, electrical signal, or light results in a change in the absorption spectrum and intensity.« less

  6. Depressive symptoms, satisfaction with health care, and 2-year work outcomes in an employed population.

    PubMed

    Druss, B G; Schlesinger, M; Allen, H M

    2001-05-01

    The relationship of depressive symptoms, satisfaction with health care, and 2-year work outcomes was examined in a national cohort of employees. A total of 6,239 employees of three corporations completed surveys on health and satisfaction with health care in 1993 and 1995. This study used bivariate and multivariate analyses to examine the relationships of depressive symptoms (a score below 43 on the Medical Outcomes Study Short-Form Health Survey mental component summary), satisfaction with a variety of dimensions of health care in 1993, and work outcomes (sick days and decreased effectiveness in the workplace) in 1995. The odds of missed work due to health problems in 1995 were twice as high for employees with depressive symptoms in both 1993 and 1995 as for those without depressive symptoms in either year. The odds of decreased effectiveness at work in 1995 was seven times as high. Among individuals with depressive symptoms in 1993, a report of one or more problems with clinical care in 1993 predicted a 34% increase in the odds of persistent depressive symptoms and a 66% increased odds of decreased effectiveness at work in 1995. There was a weaker association between problems with plan administration and outcomes. Depressive disorders in the workplace persist over time and have a major effect on work performance, most notably on "presenteeism," or reduced effectiveness in the workplace. The study's findings suggest a potentially important link between consumers' perceptions of clinical care and work outcomes in this population.

  7. Differential impact of five coronary devices on plaque size: insights from the ABSORB and SPIRIT trials.

    PubMed

    García-García, Héctor M; Serruys, Patrick W; Campos, Carlos M; Onuma, Yoshinobu

    2014-08-20

    Coronary plaque size modification, by either local (device) or systemic treatments, has been the target for many years. From ABSORB Cohort A (Absorb BVS 1.0), ABSORB Cohort B (Absorb BVS 1.1), SPIRIT FIRST (Multi-Link Vision vs. Xience V) & SPIRIT II (Xience V vs. Taxus), we calculated the total plaque area (vessel minus lumen area - thus it comprises both compartments - the plaque behind struts and the neointima.) changes by IVUS. A total of 313 patients were included. Comparison-at-6-month follow-up: All devices induced an increase in the total plaque area. The largest increase occurred with Vision and Taxus stents as compared to other devices [Absorb BVS (1.0 and 1.1) and Xience V], (p=0.0002). Comparison-at-2-year follow-up: Absorb BVS 1.1 had a larger increase from post procedure in total plaque compared to Absorb BVS 1.0, Xience V and Taxus (p=0.0499). However, in Absorb BVS 1.1 total plaque showed a reduction of 2.2% from 1 to 3 years. Specifically, the total plaque in the sequential cohorts of Absorb BVS 1.1 increased 16.2% from baseline to 2 years (Cohort B1) while at 3 years this increase is only 5% compared to baseline (Cohort B2). Local devices affect coronary plaque size differently and it depends on the platform (metallic vs. polymeric) and on whether it is a bare - or drug eluting stent. Coronary scaffolds appear to be a promising alternative to metallic stents since they allow plaque regression at long-term follow-up. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  8. A prospective 2-year examination of cognitive and behavioral correlates of provoked vestibulodynia outcomes.

    PubMed

    Davis, Seth N P; Bergeron, Sophie; Bois, Katy; Sadikaj, Gentiana; Binik, Yitzchak M; Steben, Marc

    2015-04-01

    Provoked vestibulodynia (PVD) is a common genital pain disorder in women that is associated with sexual dysfunction and lowered sexual satisfaction. A potentially applicable cognitive-behavioral model of chronic pain and disability is the fear-avoidance model (FAM) of pain. The FAM posits that cognitive variables, such as pain catastrophizing, fear, and anxiety lead to avoidance of pain-provoking behaviors (eg, intercourse), resulting in continued pain and disability. Although some of the FAM variables have been shown to be associated with PVD pain and sexuality outcomes, the model as a whole has never been tested in this population. An additional protective factor, pain self-efficacy (SE), is also associated with PVD, but has not been tested within the FAM model. Using a 2-year longitudinal design, we examine (1) whether initial levels (T1) of the independent FAM variables and pain SE were associated with changes in pain, sexual function, and sexual satisfaction over the 2-year time period; (2) the prospective contribution of changes in cognitive-affective (FAM) variables to changes in pain, and sexuality outcomes; and (3) whether these were mediated by behavioral change (avoidance of intercourse). A sample of 222 women with PVD completed self-report measures of FAM variables, SE, pain, sexual function, and sexual satisfaction at time 1 and at a 2-year follow-up. Structural equation modeling with Latent Difference Scores was used to examine changes and to examine mediation between variables. Questionnaires included the Pain Catastrophizing Scale, McGill Pain Questionnaire, Trait Anxiety Inventory, Pain Self-Efficacy Scale, and Global Measure of Sexual Satisfaction, Female Sexual Function Index. Participants who reported higher SE at T1 reported greater declines in pain, greater increases in sexual satisfaction, and greater declines in sexual function over the 2 time points. The overall change model did not support the FAM using negative cognitive

  9. Combinatorial development of Cu2SnS3 as an earth abundant photovoltaic absorber

    NASA Astrophysics Data System (ADS)

    Baranowski, Lauryn L.

    The development of high efficiency, earth abundant photovoltaic absorbers is critical if photovoltaics are to be implemented on the TW scale. Although traditional thin films absorbers such as Cu(In,Ga)Se2 and CdTe have achieved over 20% device efficiencies, the ultimately scalability of these devices may be limited by elemental scarcity and toxicity issues. To date, the most successful earth abundant thin film absorber is Cu2ZnSn(S,Se) 4, which has achieved 12.6% efficiency as of 2014. However, chemical complexity and disorder issues with this material have made the path to higher efficiency CZTSSe devices unclear. As a result, many researchers are now exploring alternative earth abundant absorber materials. In this thesis, we apply our "rapid development" methodology to the exploration of alternative photovoltaic absorbers. The rapid development (RD) methodology, consisting of exploration, research, and development stages, uses complementary theory and experiment to assess candidate materials and down-select in each stage. The overall result is that, in the time span of ~2-3 years, we are able to rapidly go from tens of possible absorber materials to 1-2 working PV device prototypes. Here, we demonstrate the RD approach as applied to the Cu-Sn-S system. We begin our investigation of the Cu-Sn-S system by evaluating the thermodynamic stability, electrical transport, electronic structure, and optical and defect properties of candidate materials using complementary theory and experiment. We find that Cu2SnS3 is the most promising absorber candidate because of its strong optical absorption, tunable doping, and wide stability range. Our other candidate compounds suffer from serious flaws that preclude them from being successful photovoltaic absorbers, including too high experimental conductivity (Cu4SnS4), or poor hole transport and low absorption coefficient (Cu4Sn7S16). Next, we investigate the doping and defect physics of Cu2SnS 3. We identify the origins of the

  10. ARMS2 variants may predict the 3-year outcome of photodynamic therapy for wet age-related macular degeneration

    PubMed Central

    Nakai, Shunichiro; Matsumiya, Wataru; Miki, Akiko; Nakamura, Makoto

    2017-01-01

    Purpose To determine the association of age-related maculopathy susceptibility 2 (ARMS2) gene polymorphisms with the 3-year outcomes of photodynamic therapy (PDT) in wet age-related macular degeneration (wet AMD). Methods The single nucleotide polymorphism (SNP) at rs10490924 in the ARMS2 gene of 65 patients with wet AMD who underwent PDT was genotyped using the TaqMan assay. The clinical characteristics and the outcomes of PDT were compared among the three genotypes at rs10490924. A multivariate regression analysis was performed to evaluate the influence of the clinical cofactors on the association of rs10490924 with the visual outcome at 36 months after the first PDT. Results A significant difference was found among the genotypes in the age and the baseline lesion size. The patients with the GG genotype showed a significant improvement in vision, and the patients with the TT genotype showed a significant worsening of vision at all time points measured after the initial PDT. In the multivariate regression analysis, the number of the G allele at rs10490924 was associated with a significantly greater improvement in the baseline best-corrected visual acuity (BCVA) at 36 months after the first PDT. Conclusions ARMS2 variants are likely associated with the 3-year outcomes of PDT in patients with wet AMD. PMID:28761324

  11. Navigation-assisted versus conventional total knee replacement: no difference in patient-reported outcome measures (PROMs) at 1 and 2 years.

    PubMed

    Singisetti, Kiran; Muthumayandi, Karthikeyan; Abual-Rub, Zaid; Weir, David

    2015-11-01

    Navigation technique for total knee replacement has been shown to improve accuracy of prosthesis alignment in several studies. The purpose was to compare the patient-reported outcome measures in primary total knee replacement (TKR) using navigation versus conventional surgical technique at 1- and 2-year follow-up. A retrospective review of prospectively collected patient-reported outcome data for 351 consecutively performed primary TKR was included in the study. The study group (N = 113) included patients who had Triathlon TKR using articular surface mounted (ASM Stryker) navigation technique and control group (N = 238) included patients who had Triathlon TKR using conventional jig. In addition to the WOMAC (Western Ontario and McMaster University Osteoarthritis Index) and SF-36 (Medical Outcomes Trust Short Form-36), a short self-report questionnaire evaluating the level of satisfaction, quality of life and whether patients would undergo knee replacement again. WOMAC: no significant difference between the groups was noted in mean WOMAC pain, function and stiffness scores at 1- and 2-year follow-up. SF-36: no significant difference between the groups was seen except in the physical function component of score at 1 year (p = 0.019). Navigation group mean 56.78 (CI 51.06-62.5) versus conventional group mean 48.34 (44.68-52.01) but this difference was not observed at 2-year follow-up. The overall patient-reported outcome scores improved after total knee replacement but appear to be comparable in both groups at 1- and 2-year follow-up.

  12. Kidney Outcomes 5 Years After Pediatric Cardiac Surgery

    PubMed Central

    Greenberg, Jason H.; Zappitelli, Michael; Devarajan, Prasad; Thiessen-Philbrook, Heather R.; Krawczeski, Catherine; Li, Simon; Garg, Amit X.; Coca, Steve; Parikh, Chirag R.

    2017-01-01

    IMPORTANCE Acute kidney injury (AKI) after pediatric cardiac surgery is associated with high short-term morbidity and mortality; however, the long-term kidney outcomes are unclear. OBJECTIVE To assess long-term kidney outcomes after pediatric cardiac surgery and to determine if perioperative AKI is associated with worse long-term kidney outcomes. DESIGN, SETTING, AND PARTICIPANTS This prospective multicenter cohort study recruited children between ages 1 month to 18 years who underwent cardiopulmonary bypass for cardiac surgery and survived hospitalization from 3 North American pediatric centers between July 2007 and December 2009. Children were followed up with telephone calls and an in-person visit at 5 years after their surgery. EXPOSURES Acute kidney injury defined as a postoperative serum creatinine rise from preoperative baseline by 50% or 0.3 mg/dL or more during hospitalization for cardiac surgery. MAIN OUTCOMES AND MEASURES Hypertension (blood pressure ≥95th percentile for height, age, sex, or self-reported hypertension), microalbuminuria (urine albumin to creatinine ratio >30 mg/g), and chronic kidney disease (serum creatinine estimated glomerular filtration rate [eGFR] <90 mL/min/1.73 m2 or microalbuminuria). RESULTS Overall, 131 children (median [interquartile range] age, 7.7 [5.9–9.9] years) participated in the 5-year in-person follow-up visit; 68 children (52%) were male. Fifty-seven of 131 children (44%) had postoperative AKI. At follow-up, 22 children (17%) had hypertension (10 times higher than the published general pediatric population prevalence), while 9 (8%), 13 (13%), and 1 (1%) had microalbuminuria, an eGFR less than 90 mL/min/1.73 m2, and an eGFR less than 60 mL/min/1.73 m2, respectively. Twenty-one children (18%) had chronic kidney disease. Only 5 children (4%) had been seen by a nephrologist during follow-up. There was no significant difference in renal outcomes between children with and without postoperative AKI. CONCLUSIONS AND

  13. Radioiodine therapy in Graves' disease based on tissue-absorbed dose calculations: effect of pre-treatment thyroid volume on clinical outcome.

    PubMed

    Reinhardt, Michael J; Brink, Ingo; Joe, Alexius Y; Von Mallek, Dirk; Ezziddin, Samer; Palmedo, Holger; Krause, Thomas M

    2002-09-01

    This study was performed with three aims. The first was to analyse the effectiveness of radioiodine therapy in Graves' disease patients with and without goitres under conditions of mild iodine deficiency using several tissue-absorbed doses. The second aim was to detect further parameters which might be predictive for treatment outcome. Finally, we wished to determine the deviation of the therapeutically achieved dose from that intended. Activities of 185-2,220 MBq radioiodine were calculated by means of Marinelli's formula to deliver doses of 150, 200 or 300 Gy to the thyroids of 224 patients with Graves' disease and goitres up to 130 ml in volume. Control of hyperthyroidism, change in thyroid volume and thyrotropin-receptor antibodies were evaluated 15+/-9 months after treatment for each dose. The results were further evaluated with respect to pre-treatment parameters which might be predictive for therapy outcome. Thyroidal radioiodine uptake was measured every day during therapy to determine the therapeutically achieved target dose and its coefficient of variation. There was a significant dose dependency in therapeutic outcome: frequency of hypothyroidism increased from 27.4% after 150 Gy to 67.7% after 300 Gy, while the frequency of persistent hyperthyroidism decreased from 27.4% after 150 Gy to 8.1% after 300 Gy. Patients who became hypothyroid had a maximum thyroid volume of 42 ml and received a target dose of 256+/-80 Gy. The coefficient of variation for the achieved target dose ranged between 27.7% for 150 Gy and 17.8% for 300 Gy. When analysing further factors which might influence therapeutic outcome, only pre-treatment thyroid volume showed a significant relationship to the result of treatment. It is concluded that a target dose of 250 Gy is essential to achieve hypothyroidism within 1 year after radioiodine therapy in Graves' disease patients with goitres up to 40 ml in volume. Patients with larger goitres might need higher doses.

  14. Prediction of outcome at 5 years from assessments at 2 years among extremely preterm children: a Norwegian national cohort study.

    PubMed

    Leversen, Katrine Tyborg; Sommerfelt, Kristian; Elgen, Irene Bircow; Eide, Geir Egil; Irgens, Lorentz M; Júlíusson, Pétur B; Markestad, Trond

    2012-03-01

    To examine the predictive value of early assessments on developmental outcome at 5 years in children born extremely preterm. This is a prospective observational study of all infants born in Norway in 1999-2000 with gestational age (GA) <28 weeks or birth weight (BW) <1000 g. At 2 years of age, paediatricians assessed mental and motor development from milestones. At 5 years, parents completed questionnaires on development and professional support before cognitive function was assessed with Wechsler Preschool and Primary Scale of Intelligence-Revised (WPPSI-R) and motor function with the Movement Assessment Battery for children (ABC test). Twenty-six of 373 (7%) children had cerebral palsy at 2 and 29 of 306 (9%) children at 5 years. Of children without major impairments, 51% (95% CI 35-67) of those with and 22% (95% CI 16-28) without mental delay at 2 years had IQ <85 at 5 years, and 36% (95% CI 20-53 with and 16% (95% CI 11-21) without motor delay at 2 years had an ABC score >95th percentile (poor function). Approximately half of those without major impairments but IQ <85 or ABC score >95th percentile had received support or follow-up beyond routine primary care. Previous assessments had limited value in predicting cognitive and motor function at 5 years in these extremely preterm children without major impairments. © 2011 The Author(s)/Acta Paediatrica © 2011 Foundation Acta Paediatrica.

  15. [The LORAS project and quality assurance. In four years from input- to outcome-oriented financing in public health. 2: LORAS project outcome parts 1 & 98].

    PubMed

    Lenz, M J; Hochreutener, M A

    2001-04-01

    This series of three articles is a summary of the operations, findings and results of the hospital reform projects in the Canton of Zurich, termed LORAS. With the aid of the LORAS project within four years Zurich hospitals have been transformed. Whereas they used to adhere to input-oriented covering of deficits they now operate with outcome-oriented prospective financing of output. Part 1 describes the whole project. Part 2 focuses on the development of outcome-measurement. Part 3 finally describes the implementation of the outcome-measurement in the canton of Zurich.

  16. Intravitreal aflibercept for neovascular age-related macular degeneration in patients aged 90 years or older: 2-year visual acuity outcomes.

    PubMed

    Chatziralli, Irini; Regan, Shane O; Mohamed, Ryian; Talks, James; Sivaprasad, Sobha

    2018-06-04

    The purpose of this study was to investigate the efficacy of intravitreal aflibercept for neovascular age-related macular degeneration (nAMD) in very elderly patients aged 90 years or older at 2 years after treatment initiation. In this multicentre retrospective data analysis from electronic medical record, consecutive treatment-naive patients with nAMD treated with aflibercept with at least 2 years follow-up were stratified into those aged < 90 years (Group I) and an older cohort aged 90 and over (Group II). We compared the visual acuity (EDTRS letters) outcomes at 4 weekly intervals between the two groups over a 2-year period. The mean visual acuity of Group I at presentation was 56.3 ETDRS letters versus 52.8 letters in Group II. Maximal visual acuity was achieved in both the groups by 6 months after initiating treatment (4.7 vs. 4.0 letters gain). By 2 years, the mean visual acuity of the older cohort fell marginally below their baseline visual acuity (0.8 letter loss), while Group I presented +2.1 letters gain. The number of injections given and the retention rate of the older cohort were no different to the rest of the patients. Very old patients with nAMD benefited from aflibercept, but not to the same degree as the younger patients. The study showed that, on an average, the very elderly patients were able to adhere to the intensive anti-VEGF treatment regimens.

  17. Brief review of emerging photovoltaic absorbers

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Zakutayev, Andriy

    Photovoltaic solar cells have recently made significant commercial progress and are on track toward meeting more than 1% of global energy demand. However, further research is needed on photovoltaic technologies that face no scalability constraints in generating more than 10% of the world's electricity. This 2017 article briefly reviews emerging photovoltaic absorber materials, focusing on research progress over the past 2-3 years. Particular emphasis is given to emerging solar cell absorbers -- for example, SnS, Sb 2Se 3, Cu 2SnS 3, and CuSbSe 2 -- related to established solar cell technologies such as CdTe, Cu(In,Ga)Se 2, and CH 3NH 3PbImore » 3. Lastly, the general publication and performance trends are discussed, and the promising future research directions are pointed out.« less

  18. Brief review of emerging photovoltaic absorbers

    DOE PAGES

    Zakutayev, Andriy

    2017-02-08

    Photovoltaic solar cells have recently made significant commercial progress and are on track toward meeting more than 1% of global energy demand. However, further research is needed on photovoltaic technologies that face no scalability constraints in generating more than 10% of the world's electricity. This 2017 article briefly reviews emerging photovoltaic absorber materials, focusing on research progress over the past 2-3 years. Particular emphasis is given to emerging solar cell absorbers -- for example, SnS, Sb 2Se 3, Cu 2SnS 3, and CuSbSe 2 -- related to established solar cell technologies such as CdTe, Cu(In,Ga)Se 2, and CH 3NH 3PbImore » 3. Lastly, the general publication and performance trends are discussed, and the promising future research directions are pointed out.« less

  19. Metal Oxide/Zeolite Combination Absorbs H2S

    NASA Technical Reports Server (NTRS)

    Voecks, Gerald E.; Sharma, Pramod K.

    1989-01-01

    Mixed copper and molybdenum oxides supported in pores of zeolite found to remove H2S from mixture of gases rich in hydrogen and steam, at temperatures from 256 to 538 degree C. Absorber of H2S needed to clean up gas streams from fuel processors that incorporate high-temperature steam reformers or hydrodesulfurizing units. Zeolites chosen as supporting materials because of their high porosity, rigidity, alumina content, and variety of both composition and form.

  20. Heterotopic ossification and clinical outcome in nonconstrained cervical arthroplasty 2 years after surgery: the Norwegian Cervical Arthroplasty Trial (NORCAT).

    PubMed

    Sundseth, Jarle; Jacobsen, Eva Astrid; Kolstad, Frode; Sletteberg, Ruth O; Nygaard, Oystein P; Johnsen, Lars Gunnar; Pripp, Are Hugo; Andresen, Hege; Fredriksli, Oddrun Anita; Myrseth, Erling; Zwart, John A

    2016-07-01

    Heterotopic ossification is a phenomenon in cervical arthroplasty. Previous reports have mainly focused on various semiconstrained devices and only a few publications have focused on ossification around devices that are nonconstrained. The purpose of this study was to assess the occurrence of heterotopic ossification around a nonconstrained cervical device and how it affects clinical outcome 2 years after surgery. Thirty-seven patients were included from a larger cohort of a randomized controlled trial (NORCAT) which compared single-level cervical arthroplasty with fusion. The occurrence of heterotopic ossification was assessed with a CT scan and two neuroradiologists determined its degree. For grading, we used the Mehren/Suchomel classification system (grade 0-4). The patients were divided by level of ossification, low grade (0-2) or high grade (3-4), and clinical outcomes were compared. Self-rated disability for neck and arm pain (Neck Disability Index), health-related quality of life (the Short Form-36 and EuroQol-5D), and pain (the Numeric Rating Scale 11) were used as clinical outcome measures. Heterotopic ossification was encountered in all patients 2 years after surgery. Complete fusion (grade 4) was found in 16 % of participants, and high-grade ossification (grade 3-4) occurred in 62 %. The remaining patients were classified as having low-grade ossification (grade 2). There were no differences in the clinical outcomes of patients with low- and high-grade ossification. High-grade heterotopic ossification and spontaneous fusion 2 years after surgery were seen in a significant number of patients. However, the degree of ossification did not influence the clinical outcome.

  1. The Bangladesh clubfoot project: audit of 2-year outcomes of Ponseti treatment in 400 children.

    PubMed

    Perveen, Roksana; Evans, Angela M; Ford-Powell, Vikki; Dietz, Frederick R; Barker, Simon; Wade, Paul W; Khan, Shariful I

    2014-01-01

    Congenital clubfoot deformity can cause significant disability, and if left untreated, may further impoverish those in developing countries, like Bangladesh. The Ponseti method has been strategically introduced in Bangladesh by a nongovernment organization, Walk For Life (WFL). WFL has provided free treatment for over 8000 Bangladeshi children with clubfeet, sustained by local ownership, and international support. This audit assesses the 2-year results in children for whom treatment began before the age of 3 years. The 10 largest WFL clinics, of the 24 across Bangladesh, were pragmatically accessed in this audit availing 1442 subjects meeting the study criteria, from which 400 children were randomly selected and examined. A specific assessment tool was developed and validated. Results for 400 cases were returned: 269 males, 131 females. Typical clubfeet comprised 79% of cases, and 55% were bilateral. A tenotomy rate of 79%, and brace use after 2 years of 85%, were notable findings. Functionally, most children could walk independently (99.0%), run (95.5%), squat (93.3%), and manage steps unassisted (93.0%). The ability to squat was the most indicative outcome measure, correlating with: less corrective casts, good and continued brace use, nonvarus heel position, good ankle range of motion, good Bangla clubfoot scores, and the ability to walk. Relapsing deformity was suspected with heel varus (18.0% left; 21.5% right). Parental satisfaction was very high, but cost of 3000 Taka ($US 38.48) was deemed unaffordable by 59%. The outcomes in young children after 2 years of Ponseti treatment for clubfoot deformity showed that 99% were able to walk independently. The assessment tool developed for this study avails ongoing monitoring. Without the patronage of WFL, most of these children would not have had access to treatment, and be unable to walk. Level II-lesser-quality prospective study.

  2. One-year outcomes after rapid-deployment aortic valve replacement.

    PubMed

    Young, Christopher; Laufer, Günther; Kocher, Alfred; Solinas, Marco; Alamanni, Francesco; Polvani, Gianluca; Podesser, Bruno K; Aramendi, Jose Ignacio; Arribas, Jose; Bouchot, Olivier; Livi, Ugolino; Massetti, Massimo; Terp, Kim; Giot, Christophe; Glauber, Mattia

    2018-02-01

    The goals of rapid-deployment aortic valve replacement include facilitation of minimally invasive surgery and reduced aortic crossclamp time. We report the short-term outcomes of a series of 493 patients undergoing rapid-deployment aortic valve replacement with the EDWARDS INTUITY valve system (Edwards Lifesciences, LLC, Irvine, Calif). Assessing Standard oF Care and Clinical Outcomes UsiNg the EDWARDS INTUITY VAlve SysTem in a European multI-center, Active, pOst-market surveillaNce Study was a prospective, multicenter (n = 26) European registry designed to evaluate the safety and performance of the valve system. During rapid-deployment aortic valve replacement, device technical success and crossclamp time were assessed. Procedural outcomes, hemodynamic performance, and various adverse events and clinical outcomes were evaluated up to 2 years. Between 2012 and 2014, 493 of 517 enrolled patients successfully received implants with the study valve (95.4% technical success). Mean crossclamp times for 163 full sternotomies, 128 mini-upper sternotomies, and 36 right anterior thoracotomies isolated aortic valve replacements were 47.3, 52.0, and 73.3 minutes, respectively. Mean follow-up was 1.8 years, with 870 total patient-years of follow-up. Mean effective orifice area increased from 0.72 (baseline) to 1.88 cm 2 , and mean pressure gradient decreased from 47.6 to 9.6 mm Hg (1 year). Mean effective orifice area index increased (0.39-1.01 cm 2 /m 2 ), and 28 of 287 patients (9.8%) exhibited severe prosthesis-patient mismatch at 1 year. After 1 year, 68.1% and 21.7% of patients were in New York Heart Association class I and II, respectively. Freedom from death, major bleeding, major perivalvular leak, reoperation, and device explant at 1 year were 0.935, 0.939, 0.976, 0.975, and 0.983, respectively. These results demonstrate commendable safety and performance of the test valve system over the short term in a broad European setting. Copyright © 2017 The

  3. Two-year outcomes of transforaminal lumbar interbody fusion.

    PubMed

    Poh, Seng Yew; Yue, Wai Mun; Chen, Li-Tat John; Guo, Chang-Ming; Yeo, William; Tan, Seang-Beng

    2011-08-01

    To evaluate the outcomes, fusion rates, complications, and adjacent segment degeneration associated with transforaminal lumbar interbody fusion (TLIF). 32 men and 80 women aged 15 to 85 (mean, 57) years underwent 141 fusions (84 one-level, 27 2-level, and one 3-level) and were followed up for 24 to 76 (mean, 33) months. 92% of the patients had degenerative lumbar disease, 15 of whom had had previous lumbar surgery. Radiographic and clinical outcomes were assessed at 2 years. The short-form 36 (SF-36) health survey, visual analogue scale (VAS) for pain, and the modified North American Spine Society (NASS) Low Back Pain Outcome Instrument were used. Of the 141 levels fused, 110 (78%) were fused with remodelling and trabeculae (grade I), and 31 (22%) had intact grafts but were not fully incorporated (grade II). No patient had pseudoarthroses (grade III or IV). For one-level fusions, poorer radiological fusion grades correlated with higher VAS scores for pain (p<0.01). All components of the SF-36, the VAS scores for pain, and the NASS scores improved significantly after TLIF (p<0.01), except for general health in the SF-36 (p=0.59). Improvement from postoperative 6 months to 2 years was not significant, except for physical function (p<0.01) and role function (physical) [p=0.01] in the SF-36. Two years after TLIF, 50% of the patients reported returning to full function, whereas 72% were satisfied. 26 (23%) of the patients had adjacent segment degeneration, but only 4 of them were symptomatic. TLIF is a safe and effective treatment for degenerative lumbar diseases.

  4. Shock Absorbing System

    NASA Technical Reports Server (NTRS)

    1982-01-01

    A lightweight, inexpensive shock-absorbing system, developed by Langley Research Center 20 years ago, is now in service as safety device for an automated railway at Duke University Medical Center. The transportation system travels at about 25 miles per hour, carrying patients, visitors, staff and cargo. At the end of each guideway of the system are "frangible," (breakable) tube "buffers." If a slowing car fails to make a complete stop at the terminal, it would bump and shatter the tubes, absorbing energy that might otherwise jolt the passengers or damage the vehicle.

  5. Spatial variation of PM2.5, PM10, PM2.5 absorbance and PMcoarse concentrations between and within 20 European study areas and the relationship with NO2 - Results of the ESCAPE project

    NASA Astrophysics Data System (ADS)

    Eeftens, Marloes; Tsai, Ming-Yi; Ampe, Christophe; Anwander, Bernhard; Beelen, Rob; Bellander, Tom; Cesaroni, Giulia; Cirach, Marta; Cyrys, Josef; de Hoogh, Kees; De Nazelle, Audrey; de Vocht, Frank; Declercq, Christophe; Dėdelė, Audrius; Eriksen, Kirsten; Galassi, Claudia; Gražulevičienė, Regina; Grivas, Georgios; Heinrich, Joachim; Hoffmann, Barbara; Iakovides, Minas; Ineichen, Alex; Katsouyanni, Klea; Korek, Michal; Krämer, Ursula; Kuhlbusch, Thomas; Lanki, Timo; Madsen, Christian; Meliefste, Kees; Mölter, Anna; Mosler, Gioia; Nieuwenhuijsen, Mark; Oldenwening, Marieke; Pennanen, Arto; Probst-Hensch, Nicole; Quass, Ulrich; Raaschou-Nielsen, Ole; Ranzi, Andrea; Stephanou, Euripides; Sugiri, Dorothee; Udvardy, Orsolya; Vaskövi, Éva; Weinmayr, Gudrun; Brunekreef, Bert; Hoek, Gerard

    2012-12-01

    The ESCAPE study (European Study of Cohorts for Air Pollution Effects) investigates relationships between long-term exposure to outdoor air pollution and health using cohort studies across Europe. This paper analyses the spatial variation of PM2.5, PM2.5 absorbance, PM10 and PMcoarse concentrations between and within 20 study areas across Europe.We measured NO2, NOx, PM2.5, PM2.5 absorbance and PM10 between October 2008 and April 2011 using standardized methods. PMcoarse was determined as the difference between PM10 and PM2.5. In each of the twenty study areas, we selected twenty PM monitoring sites to represent the variability in important air quality predictors, including population density, traffic intensity and altitude. Each site was monitored over three 14-day periods spread over a year, using Harvard impactors. Results for each site were averaged after correcting for temporal variation using data obtained from a reference site, which was operated year-round.Substantial concentration differences were observed between and within study areas. Concentrations for all components were higher in Southern Europe than in Western and Northern Europe, but the pattern differed per component with the highest average PM2.5 concentrations found in Turin and the highest PMcoarse in Heraklion. Street/urban background concentration ratios for PMcoarse (mean ratio 1.42) were as large as for PM2.5 absorbance (mean ratio 1.38) and higher than those for PM2.5 (1.14) and PM10 (1.23), documenting the importance of non-tailpipe emissions. Correlations between components varied between areas, but were generally high between NO2 and PM2.5 absorbance (average R2 = 0.80). Correlations between PM2.5 and PMcoarse were lower (average R2 = 0.39). Despite high correlations, concentration ratios between components varied, e.g. the NO2/PM2.5 ratio varied between 0.67 and 3.06.In conclusion, substantial variability was found in spatial patterns of PM2.5, PM2.5 absorbance, PM10 and PMcoarse. The

  6. The COMMENCE trial: 2-year outcomes with an aortic bioprosthesis with RESILIA tissue.

    PubMed

    Puskas, John D; Bavaria, Joseph E; Svensson, Lars G; Blackstone, Eugene H; Griffith, Bartley; Gammie, James S; Heimansohn, David A; Sadowski, Jerzy; Bartus, Krzysztof; Johnston, Douglas R; Rozanski, Jacek; Rosengart, Todd; Girardi, Leonard N; Klodell, Charles T; Mumtaz, Mubashir A; Takayama, Hiroo; Halkos, Michael; Starnes, Vaughn; Boateng, Percy; Timek, Tomasz A; Ryan, William; Omer, Shuab; Smith, Craig R

    2017-09-01

    The COMMENCE trial was conducted to evaluate the safety and effectiveness of a novel bioprosthetic tissue for surgical aortic valve replacement (AVR). Patients underwent clinically indicated surgical AVR with the Carpentier-Edwards PERIMOUNT™ Magna Ease™ aortic valve with RESILIA™ tissue (Model 11000A) in a prospective, multinational, multicentre (n = 27), single-arm, FDA Investigational Device Exemption trial. Events were adjudicated by an independent Clinical Events Committee; echocardiograms were analysed by an independent Core Laboratory. Between January 2013 and February 2016, 689 patients received the study valve. Mean age was 67.0 ± 11.6 years; 71.8% were male; 26.3% were New York Heart Association Class III/IV. Mean STS PROM was 2.0 ± 1.8 (0.3-17.5). Isolated AVR was performed in 59.1% of patients; others had additional concomitant procedures, usually CABG. Thirty-day outcomes for all patients included all-cause mortality 1.2%, thromboembolism 2.2%, bleeding 0.9%, major paravalvular leak 0.1% and permanent pacemaker implantation 4.7%. Median intensive care unit and hospital length of stay were 2 (range: 0.2-66) and 7 days (3.0-121.0), respectively. At 2years, New York Heart Association class improved in 65.7%, effective orifice area was 1.6 ± 0.5 cm2; mean gradient was 10.1 ± 4.3 mmHg; and paravalvular leak was none/trivial in 94.5%, mild in 4.9%, moderate in 0.5% and severe in 0.0%. One-year actuarial freedom from all-cause mortality for isolated AVR and for all patients was 98.2% and 97.6%, respectively. Two-year actuarial freedom from mortality in these groups was 95.3% and 94.3%, respectively. These data demonstrate excellent early safety and effectiveness of aortic valve replacement with a novel bioprosthetic tissue (RESILIA™). clinicaltrials.gov: NCT01757665. © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  7. Air-Leak Effects on Ear-Canal Acoustic Absorbance

    PubMed Central

    Rasetshwane, Daniel M.; Kopun, Judy G.; Gorga, Michael P.; Neely, Stephen T.

    2015-01-01

    Objective: Accurate ear-canal acoustic measurements, such as wideband acoustic admittance, absorbance, and otoacoustic emissions, require that the measurement probe be tightly sealed in the ear canal. Air leaks can compromise the validity of the measurements, interfere with calibrations, and increase variability. There are no established procedures for determining the presence of air leaks or criteria for what size leak would affect the accuracy of ear-canal acoustic measurements. The purpose of this study was to determine ways to quantify the effects of air leaks and to develop objective criteria to detect their presence. Design: Air leaks were simulated by modifying the foam tips that are used with the measurement probe through insertion of thin plastic tubing. To analyze the effect of air leaks, acoustic measurements were taken with both modified and unmodified foam tips in brass-tube cavities and human ear canals. Measurements were initially made in cavities to determine the range of critical leaks. Subsequently, data were collected in ears of 21 adults with normal hearing and normal middle-ear function. Four acoustic metrics were used for predicting the presence of air leaks and for quantifying these leaks: (1) low-frequency admittance phase (averaged over 0.1–0.2 kHz), (2) low-frequency absorbance, (3) the ratio of compliance volume to physical volume (CV/PV), and (4) the air-leak resonance frequency. The outcome variable in this analysis was the absorbance change (Δabsorbance), which was calculated in eight frequency bands. Results: The trends were similar for both the brass cavities and the ear canals. ΔAbsorbance generally increased with air-leak size and was largest for the lower frequency bands (0.1–0.2 and 0.2–0.5 kHz). Air-leak effects were observed in frequencies up to 10 kHz, but their effects above 1 kHz were unpredictable. These high-frequency air leaks were larger in brass cavities than in ear canals. Each of the four predictor variables

  8. Air-leak effects on ear-canal acoustic absorbance.

    PubMed

    Groon, Katherine A; Rasetshwane, Daniel M; Kopun, Judy G; Gorga, Michael P; Neely, Stephen T

    2015-01-01

    Accurate ear-canal acoustic measurements, such as wideband acoustic admittance, absorbance, and otoacoustic emissions, require that the measurement probe be tightly sealed in the ear canal. Air leaks can compromise the validity of the measurements, interfere with calibrations, and increase variability. There are no established procedures for determining the presence of air leaks or criteria for what size leak would affect the accuracy of ear-canal acoustic measurements. The purpose of this study was to determine ways to quantify the effects of air leaks and to develop objective criteria to detect their presence. Air leaks were simulated by modifying the foam tips that are used with the measurement probe through insertion of thin plastic tubing. To analyze the effect of air leaks, acoustic measurements were taken with both modified and unmodified foam tips in brass-tube cavities and human ear canals. Measurements were initially made in cavities to determine the range of critical leaks. Subsequently, data were collected in ears of 21 adults with normal hearing and normal middle-ear function. Four acoustic metrics were used for predicting the presence of air leaks and for quantifying these leaks: (1) low-frequency admittance phase (averaged over 0.1-0.2 kHz), (2) low-frequency absorbance, (3) the ratio of compliance volume to physical volume (CV/PV), and (4) the air-leak resonance frequency. The outcome variable in this analysis was the absorbance change (Δabsorbance), which was calculated in eight frequency bands. The trends were similar for both the brass cavities and the ear canals. ΔAbsorbance generally increased with air-leak size and was largest for the lower frequency bands (0.1-0.2 and 0.2-0.5 kHz). Air-leak effects were observed in frequencies up to 10 kHz, but their effects above 1 kHz were unpredictable. These high-frequency air leaks were larger in brass cavities than in ear canals. Each of the four predictor variables exhibited consistent dependence on

  9. Academic Outcomes 2 Years After Working Memory Training for Children With Low Working Memory: A Randomized Clinical Trial.

    PubMed

    Roberts, Gehan; Quach, Jon; Spencer-Smith, Megan; Anderson, Peter J; Gathercole, Susan; Gold, Lisa; Sia, Kah-Ling; Mensah, Fiona; Rickards, Field; Ainley, John; Wake, Melissa

    2016-05-02

    Working memory training may help children with attention and learning difficulties, but robust evidence from population-level randomized controlled clinical trials is lacking. To test whether a computerized adaptive working memory intervention program improves long-term academic outcomes of children 6 to 7 years of age with low working memory compared with usual classroom teaching. Population-based randomized controlled clinical trial of first graders from 44 schools in Melbourne, Australia, who underwent a verbal and visuospatial working memory screening. Children were classified as having low working memory if their scores were below the 15th percentile on either the Backward Digit Recall or Mister X subtest from the Automated Working Memory Assessment, or if their scores were below the 25th percentile on both. These children were randomly assigned by an independent statistician to either an intervention or a control arm using a concealed computerized random number sequence. Researchers were blinded to group assignment at time of screening. We conducted our trial from March 1, 2012, to February 1, 2015; our final analysis was on October 30, 2015. We used intention-to-treat analyses. Cogmed working memory training, comprising 20 to 25 training sessions of 45 minutes' duration at school. Directly assessed (at 12 and 24 months) academic outcomes (reading, math, and spelling scores as primary outcomes) and working memory (also assessed at 6 months); parent-, teacher-, and child-reported behavioral and social-emotional functioning and quality of life; and intervention costs. Of 1723 children screened (mean [SD] age, 6.9 [0.4] years), 226 were randomized to each arm (452 total), with 90% retention at 1 year and 88% retention at 2 years; 90.3% of children in the intervention arm completed at least 20 sessions. Of the 4 short-term and working memory outcomes, 1 outcome (visuospatial short-term memory) benefited the children at 6 months (effect size, 0.43 [95% CI, 0

  10. Economic Outcomes of Bioresorbable Vascular Scaffolds Versus Everolimus-Eluting Stents in Patients Undergoing Percutaneous Coronary Intervention: 1-Year Results From the ABSORB III Trial.

    PubMed

    Baron, Suzanne J; Lei, Yang; Chinnakondepalli, Khaja; Vilain, Katherine; Magnuson, Elizabeth A; Kereiakes, Dean J; Ellis, Stephen G; Stone, Gregg W; Cohen, David J

    2017-04-24

    The purpose of this study was to evaluate the economic impact of the Absorb bioresorbable vascular scaffold compared with the Xience everolimus-eluting stent in patients undergoing percutaneous coronary intervention. The ABSORB III trial (Everolimus-Eluting Bioresorbable Scaffolds for Coronary Artery Disease) demonstrated that the Absorb scaffold was noninferior to the Xience stent with respect to target lesion failure at 1 year. Whether health care costs differ between the Absorb scaffold and the Xience stent is unknown. We performed a prospective health economic study alongside the ABSORB III trial, in which patients undergoing percutaneous coronary intervention for stable or unstable angina were randomized to receive the Absorb scaffold (n = 1,322) or Xience stent (n = 686). Resource use data were collected through 1 year of follow-up. Costs were assessed using resource-based accounting (for procedures), MedPAR data (for other index hospitalization costs), and Medicare reimbursements (for follow-up costs and physician fees). Initial procedural costs were higher with the Absorb scaffold than the Xience stent ($6,316 ± 1,892 vs. $6,103 ± 1,895; p = 0.02), driven mainly by greater balloon catheter use and the higher cost of the scaffold in the Absorb group. Nonetheless, index hospitalization costs ($15,035 ± 2,992 for Absorb vs. $14,903 ± 3,449 for Xience; p = 0.37) and total 1-year costs ($17,848 ± 6,110 for Absorb vs. $17,498 ± 7,411 for Xience; p = 0.29) were similar between the 2 groups. Although initial procedural costs were higher with the Absorb scaffold, there were no differences in total 1-year health care costs between the 2 cohorts. Longer term follow-up is needed to determine whether meaningful cost savings emerge after scaffold resorption. (A Clinical Evaluation of Absorb™ BVS, the Everolimus-Eluting Bioresorbable Vascular Scaffold in the Treatment of Subjects With de Novo Native Coronary Artery Lesions; NCT01751906). Copyright © 2017

  11. Overview of the 2016 U.S. Food and Drug Administration Circulatory System Devices Advisory Panel Meeting on the Absorb Bioresorbable Vascular Scaffold System.

    PubMed

    Steinvil, Arie; Rogers, Toby; Torguson, Rebecca; Waksman, Ron

    2016-09-12

    This study aims to describe the discussions and recommendations made during the U.S. Food and Drug Administration (FDA) Circulatory System Device Panel pre-market approval application for the Absorb Bioresorbable Vascular Scaffold (BVS) System. The Absorb BVS System is a first-of-its-kind fully bioresorbable percutaneous coronary intervention technology. The absorb BVS was studied in the ABSORB III (A Clinical Evaluation of Absorb BVS, the Everolimus Eluting Bioresorbable Vascular Scaffold in the Treatment of Subjects with de Novo Native Coronary Artery Lesions) trial, the pivotal U.S. investigational device exemption trial. Observational report of the FDA Circulatory System Device Panel pre-market approval application meeting held on March 15, 2016. The U.S. FDA Circulatory System Device Panel members reviewed the ABSROB III trial outcomes and additional post hoc analyses presented by the sponsor and the FDA. The ABSORB III trial met the primary endpoint of noninferiority of Absorb BVS compared with the control, XIENCE drug-eluting stent, for target lesion failure at 1 year. Although a higher numerical trend for adverse outcomes was reported for the Absorb BVS, there were no statistical differences between Absorb BVS and XIENCE for any safety or effectiveness components for target lesion failure or for the secondary pre-specified outcomes. Panel members raised concerns with regard to the ABSORB III results and post hoc analyses focusing mainly on the noninferiority design of the trial, the apparent safety issues of the Absorb BVS in small vessels, the mismatch of visually versus intravascular imaging assessed vessel size found in ABSORB III and its implications on the adequate device labeling, the safety of Absorb BVS in specific patient and lesion subsets, and the post-approval commitments of the sponsor. Following panel discussions and the evidence presented, the panel voted for approval of the device. Copyright © 2016 American College of Cardiology Foundation

  12. Predictors of outcome after surgery with disc prosthesis and rehabilitation in patients with chronic low back pain and degenerative disc: 2-year follow-up.

    PubMed

    Hellum, Christian; Johnsen, Lars Gunnar; Gjertsen, Øyvind; Berg, Linda; Neckelmann, Gesche; Grundnes, Oliver; Rossvoll, Ivar; Skouen, Jan Sture; Brox, Jens Ivar; Storheim, Kjersti

    2012-04-01

    A prospective study to evaluate whether certain baseline characteristics can predict outcome in patients treated with disc prosthesis or multidisciplinary rehabilitation. Secondary analysis of 154 patients with chronic low back pain (LBP) for at least 1 year and degenerative discs originally recruited for a randomized trial. Outcome measures were Oswestry Disability Index (ODI) dichotomized to < or ≥15 points improvement and whether subjects were working at 2-year follow-up. A multiple logistic regression analysis was used. In patients treated with disc prosthesis, long duration of LBP and high Fear-Avoidance Beliefs for work (FABQ-W) predicted worse ODI outcome [odds ratio (OR) = 1.9, 95% confidence interval (CI) 1.2-3.2 and OR = 1.7, CI 1.2-2.4 for every 5 years or 5 points]. Modic type I or II predicted better ODI outcome (OR = 5.3, CI 1.1-25.3). In patients treated with rehabilitation, a high ODI, low emotional distress (HSCL-25), and no daily narcotics predicted better outcome for ODI (OR = 2.5, CI 1.4-4.5 for every 5 ODI points, OR = 2.1, CI 1.1-5.1 for every 0.5 HSCL points and OR = 23.6, CI 2.1-266.8 for no daily narcotics). Low FABQ-W and working at baseline predicted working at 2-year follow-up after both treatments (OR = 1.3, CI 1.0-1.5 for every 5 points and OR = 4.1, CI 1.2-13.2, respectively). Shorter duration of LBP, Modic type I or II changes and low FABQ-W were the best predictors of success after treatment with disc prosthesis, while high ODI, low distress and not using narcotics daily predicted better outcome of rehabilitation. Low FABQ-W and working predicted working at follow-up.

  13. Simple and Low-Cost Dual-Band Printed Microwave Absorber for 2.4- and 5-GHz-Band Applications

    NASA Astrophysics Data System (ADS)

    Khoomwong, Ekajit; Phongcharoenpanich, Chuwong

    2017-10-01

    In this research, a dual-band thin printed-circuit-board (PCB) microwave absorber has been proposed for applications in 2.4 and 5 GHz frequency bands. Each unit cell of the absorber consists of a square ring and a thick cross-dipole, augmented with the tuning elements. In the design process, numerical simulations were performed for the optimal characteristics of the absorber and an absorber prototype was fabricated using the simple print-transferring and etching process. The measured absorption bandwidths (50 %) of 170 MHz (2.36-2.53 GHz) and 830 MHz (5.09-5.92 GHz) were achieved for the first and second bands, respectively, with the wideband characteristic at the second operating band. The absorption rates near the center frequencies (2.45 and 5.5 GHz) were respectively 97.85 % and 97.76 %. The simulation and measured results are in good agreement. Furthermore, the incidence-angle dependencies of the absorber were of moderately wide angles with the absorption capacity of at least 50 % for both operating bands. The proposed absorber is suitable for a variety of applications requiring absorption in the 2.4/5 GHz bands.

  14. Arthroscopic Partial Repair of Irreparable Rotator Cuff Tears: Preoperative Factors Associated With Outcome Deterioration Over 2 Years.

    PubMed

    Shon, Min Soo; Koh, Kyoung Hwan; Lim, Tae Kang; Kim, Won Ju; Kim, Kyung Cheon; Yoo, Jae Chul

    2015-08-01

    Arthroscopic partial repair is a treatment option in irreparable large-to-massive rotator cuff tears without arthritic changes. However, there are indications that arthroscopic partial repair does not yield satisfactory outcomes. To report the clinical and radiographic results of arthroscopic partial repairs in patients with irreparable large-to-massive cuff tears. In addition, an analysis was performed regarding preoperative factors that may influence patient outcomes and patient-rated satisfaction over time. Case series; Level of evidence, 4. From 2005 to 2011, a total of 31 patients who underwent arthroscopic partial repair for irreparable large-to-massive cuff tears were retrospectively evaluated. Partial repair was defined as posterior cuff tissue repair with or without subscapularis tendon repair to restore the transverse force couple of the cuff. Pain visual analog scale (PVAS), questionnaire results (American Shoulder and Elbow Surgeons [ASES] and Simple Shoulder Test [SST]), and radiographic changes (acromiohumeral distance and degenerative change) were assessed preoperatively, at first follow-up (roughly 1 year postoperatively), and at final follow-up (>2 years postoperatively). Patients rated their satisfaction level at each postoperative follow-up as well. Preoperative factors that might influence outcomes, such as patient demographics, tear size, and fatty infiltration, were investigated. The preoperative, first follow-up, and final follow-up results for mean PVAS (5.13, 2.13, and 3.16, respectively) and questionnaires (ASES: 41.97, 76.37, and 73.78; SST: 3.61, 6.33, and 6.07, respectively) improved significantly (all P < .05). Radiographic evaluation showed no difference compared with preoperative status. Nevertheless, patient-rated satisfaction at final evaluation was inferior: 16 good responses ("very satisfied" and "satisfied") and 15 poor responses ("rather the same" and "dissatisfied"). Despite initial improvements in both groups (P < .05

  15. Minimum 2-year outcomes and return to sport following resection arthroplasty for the treatment of sternoclavicular osteoarthritis.

    PubMed

    Katthagen, J Christoph; Tahal, Dimitri S; Menge, Travis J; Horan, Marilee P; Millett, Peter J

    2017-02-01

    The aim of this study was to assess the effect of open resection arthroplasty for osteoarthritis of the sternoclavicular (SC) joint on pain levels, functional outcomes, and return to sport. Patients from a single surgeon's practice who underwent open resection arthroplasty (maximum 10-mm resection) for SC osteoarthritis or prearthritic changes between November 2006 and November 2013 were retrospectively reviewed. This was an outcomes study with prospectively collected data. Preoperative and postoperative American Shoulder and Elbow Surgeons score, Quick Disabilities of the Arm, Shoulder, and Hand score, Single Assessment Numeric Evaluation score, several pain scores, and level of sport intensity were assessed. Seventeen SC joints in 16 patients (9 female, 7 male) met inclusion criteria. Mean age at time of surgery way 41.1 years (range, 12-66 years). One patient refused participation in the study. Three SC joint resections (17.7%) required SC joint revision surgery. Minimum 2-year outcomes data were available for 11 of the remaining 13 SC joints (84.6%). The mean time to follow-up was 3.3 years (range, 2.0-8.8 years). Pain at its worst (P = .026), pain at competition (P = .041), the Quick Disabilities of the Arm, Shoulder, and Hand score (P = .034), and the ability to sleep on the affected shoulder (P = .038) showed significant improvement postoperatively. The average postoperative American Shoulder and Elbow Surgeons score was 83.3. The level of sports participation (P = .042) as well as strength and endurance when participating in sport (P = .039) significantly increased postoperatively. Resection arthroplasty of the medial end of the clavicle in patients with osteoarthritis of the SC joint without instability results in pain reduction, functional improvement, and a high rate of return to sport at midterm follow-up. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  16. Mid-term study of transcatheter aortic valve implantation in an Asian population with severe aortic stenosis: two-year Valve Academic Research Consortium-2 outcomes

    PubMed Central

    Chew, Nicholas; Hon, Jimmy Kim Fatt; Yip, Wei Luen James; Chan, Siew Pang; Poh, Kian-Keong; Kong, William Kok-Fai; Teoh, Kristine Leok Kheng; Yeo, Tiong Cheng; Tan, Huay Cheem; Tay, Edgar Lik Wui

    2017-01-01

    INTRODUCTION Transcatheter aortic valve implantation (TAVI) is an effective treatment for high-risk or inoperative patients with severe aortic stenosis. Given the unique characteristics of Asian populations, questions regarding mid-term outcomes in Asians undergoing TAVI have yet to be addressed. We evaluated the two-year clinical outcomes of TAVI in an Asian population using Valve Academic Research Consortium-2 definitions. METHODS This prospective study recruited 59 patients from a major academic medical centre in Singapore. The main outcomes were two-year survival rates, peri-procedural complications, symptom improvement, valvular function and assessment of learning curve. RESULTS Mean age was 76.8 years (61.0% male), mean body surface area 1.6 m2 and mean logistic EuroSCORE 18.7%. Survival was 93.2%, 86.0% and 79.1% at 30 days, one year and two years, respectively. At 30 days post TAVI, the rate of stroke was 1.7%, life-threatening bleeding 5.1%, acute kidney injury 25.0%, major vascular complication 5.1%, and new permanent pacemaker implantation 6.8%. 29.3% of TAVI patients were rehospitalised (47.1% cardiovascular-related) within one year. These composite outcomes were measured: device success (93.2%); early safety (79.7%); clinical efficacy (66.1%); and time-related valve safety (84.7%). Univariate analysis found these predictors of two-year all-cause mortality: logistic EuroSCORE (hazard ratio [HR] 1.07; p < 0.001); baseline estimated glomerular filtration rate (HR 0.97; p = 0.048); and acute kidney injury (HR 5.33; p = 0.022). Multivariate analysis identified non-transfemoral TAVI as a predictor of cardiovascular-related two-year mortality (HR 14.64; p = 0.008). CONCLUSION Despite the unique clinical differences in Asian populations, this registry demonstrated favourable mid-term clinical and safety outcomes in Asians undergoing TAVI. PMID:27516113

  17. Mid-term study of transcatheter aortic valve implantation in an Asian population with severe aortic stenosis: two-year Valve Academic Research Consortium-2 outcomes.

    PubMed

    Chew, Nicholas; Hon, Jimmy Kim Fatt; Yip, Wei Luen James; Chan, Siew Pang; Poh, Kian-Keong; Kong, William Kok-Fai; Teoh, Kristine Leok Kheng; Yeo, Tiong Cheng; Tan, Huay Cheem; Tay, Edgar Lik Wui

    2017-09-01

    Transcatheter aortic valve implantation (TAVI) is an effective treatment for high-risk or inoperative patients with severe aortic stenosis. Given the unique characteristics of Asian populations, questions regarding mid-term outcomes in Asians undergoing TAVI have yet to be addressed. We evaluated the two-year clinical outcomes of TAVI in an Asian population using Valve Academic Research Consortium-2 definitions. This prospective study recruited 59 patients from a major academic medical centre in Singapore. The main outcomes were two-year survival rates, peri-procedural complications, symptom improvement, valvular function and assessment of learning curve. Mean age was 76.8 years (61.0% male), mean body surface area 1.6 m 2 and mean logistic EuroSCORE 18.7%. Survival was 93.2%, 86.0% and 79.1% at 30 days, one year and two years, respectively. At 30 days post TAVI, the rate of stroke was 1.7%, life-threatening bleeding 5.1%, acute kidney injury 25.0%, major vascular complication 5.1%, and new permanent pacemaker implantation 6.8%. 29.3% of TAVI patients were rehospitalised (47.1% cardiovascular-related) within one year. These composite outcomes were measured: device success (93.2%); early safety (79.7%); clinical efficacy (66.1%); and time-related valve safety (84.7%). Univariate analysis found these predictors of two-year all-cause mortality: logistic EuroSCORE (hazard ratio [HR] 1.07; p < 0.001); baseline estimated glomerular filtration rate (HR 0.97; p = 0.048); and acute kidney injury (HR 5.33; p = 0.022). Multivariate analysis identified non-transfemoral TAVI as a predictor of cardiovascular-related two-year mortality (HR 14.64; p = 0.008). Despite the unique clinical differences in Asian populations, this registry demonstrated favourable mid-term clinical and safety outcomes in Asians undergoing TAVI. Copyright: © Singapore Medical Association

  18. A Ten-Year Global Record of Absorbing Aerosols Above Clouds from OMI's Near-UV Observations

    NASA Technical Reports Server (NTRS)

    Jethva, Hiren; Torres, Omar; Ahn, Changwoo

    2016-01-01

    Aerosol-cloud interaction continues to be one of the leading uncertain components of climate models, primarily due to the lack of an adequate knowledge of the complex microphysical and radiative processes associated with the aerosol-cloud system. The situations when aerosols and clouds are found in the same atmospheric column, for instance, when light-absorbing aerosols such as biomass burning generated carbonaceous particles or wind-blown dust overlay low-level cloud decks, are commonly found over several regional of the world. Contrary to the cloud-free scenario over dark surface, for which aerosols are known to produce a net cooling effect (negative radiative forcing) on climate, the overlapping situation of absorbing aerosols over cloud can potentially exert a significant level of atmospheric absorption and produces a positive radiative forcing at top-of-atmosphere. The magnitude of direct radiative effects of aerosols above cloud depends directly on the aerosol loading, microphysical-optical properties of the aerosol layer and the underlying cloud deck, and geometric cloud fraction. We help in addressing this problem by introducing a novel product of optical depth of absorbing aerosols above clouds retrieved from near-UV observations made by the Ozone Monitoring Instrument (OMI) on board NASA's Aura platform. The presence of absorbing aerosols above cloud reduces the upwelling radiation reflected by cloud and produces a strong 'color ratio' effect in the near-UV region, which can be unambiguously detected in the OMI measurements. Physically based on this effect, the OMACA algorithm retrieves the optical depths of aerosols and clouds simultaneously under a prescribed state of atmosphere. The algorithm architecture and results from a ten-year global record including global climatology of frequency of occurrence and above-cloud aerosol optical depth, and a discussion on related future field campaigns are presented.

  19. Drug-induced sedation endoscopy in children <2 years with obstructive sleep apnea syndrome: upper airway findings and treatment outcomes.

    PubMed

    Boudewyns, A; Van de Heyning, P; Verhulst, S

    2017-05-01

    Few data are available about the pattern of upper airway (UA) obstruction in children <2 years with obstructive sleep apnea syndrome (OSAS). Also, the role of adenoidectomy versus adenotonsillectomy (AT) is poorly defined in this age group. We performed drug-induced sedation endoscopy (DISE) in young OSAS children to investigate the pattern of UA obstruction and the value of DISE in therapeutic decision making. Retrospective analysis of ≤2-year-old children undergoing DISE-directed UA surgery. OSAS severity and the treatment outcomes were documented by polysomnography. Data are available for 28 patients, age 1.5 years (1.3-1.8), BMI-z score 0.5 (-0.7 to 1.3) with severe OSAS, obstructive apnea/hypopnea index (oAHI) 13.8/hr (7.5-28.3). All but 3 had (>50%) obstruction at the level of the adenoids, and all but 5 had (>50%) tonsillar obstruction. DISE-directed treatment consisted of adenoidectomy (n = 4), tonsillectomy (n = 1), and AT (n = 23). There was a significant improvement in respiratory parameters. Twenty children (71.4%) had a postoperative oAHI <2/hr. None had palatal or tongue base obstruction. Five children had a circumferential UA narrowing (hypotonia), 2 of them had residual OSAS. DISE showed a collapse of the epiglottis in 6 and late-onset laryngomalacia in 4. These findings did not affect surgical outcome. Adenotonsillar hypertrophy is the major cause of UA obstruction, and DISE-directed UA surgery was curative in 71,4% of children ≤2 years. We suggest that DISE may be helpful in surgical decision making. Circumferential UA narrowing may result in less favorable surgical outcomes.

  20. The Importance of Comprehensive Cam Correction: Radiographic Parameters Are Predictive of Patient-Reported Outcome Measures at 2 Years After Hip Arthroscopy.

    PubMed

    Lansdown, Drew A; Kunze, Kyle; Ukwuani, Gift; Waterman, Brian R; Nho, Shane J

    2018-06-01

    The specific influence of preoperative and postoperative radiographic measurements on patient-reported outcome measures after hip arthroscopy for femoroacetabular impingement (FAI) remains unclear. To investigate the relationship between radiographic measurements and 2-year outcomes after hip arthroscopy for the treatment of FAI. Case series; Level of evidence, 4. A clinical registry of patients undergoing primary hip arthroscopy for FAI between January 1, 2012, and December 31, 2014, was queried. Outcome measures included the Hip Outcome Score (HOS) Activities of Daily Living (ADL), HOS Sport-Specific Subscale (SSS), modified Harris Hip Score (mHHS), and visual analog scale (VAS) for pain and satisfaction. Preoperative and postoperative radiographic measurements were recorded. Univariate analysis was conducted to identify relationships between all radiographic and demographic variables and outcome scores. A multivariate regression analysis, controlling for demographic factors, was used to identify independent associations between radiographic measurements on plain radiographs and patient-reported outcomes. The authors identified 707 patients who underwent primary hip arthroscopic management for FAI who were included for analysis. Two-year outcome surveys were completed for 78% to 84% of patients. The mean age of the patients was 33.2 ± 12.3 years, and 64.4% of the patients (n = 456) were female. The mean anteroposterior (AP) alpha angle decreased by 34.3° ( P < .0001), false profile alpha angle by 25.2° ( P < .0001), Dunn lateral alpha angle by 28.9° ( P < .0001), lateral center edge angle by 2.6° ( P < .0001), and anterior center edge angle by 3.4° ( P < .0001). The HOS-ADL score increased from 65.7 ± 18.7 preoperatively to 85.9 ± 16.7 postoperatively ( P < .0001), HOS-SSS increased from 43.4 ± 23.1 to 72.6 ± 27.2 ( P < .0001), and mHHS increased from 57.7 ± 14.0 to 79.1 ± 17.2 ( P < .0001). With multivariate analysis, independent predictors of the

  1. Design of broadband absorber using 2-D materials for thermo-photovoltaic cell application

    NASA Astrophysics Data System (ADS)

    Agarwal, Sajal; Prajapati, Y. K.

    2018-04-01

    Present study is done to analyze a nano absorber for thermo-photovoltaic cell application. Optical absorbance of two-dimensional materials is exploited to achieve high absorbance. It is found that few alternating layers of graphene/transition metal dichalcogenide provide high absorbance of electromagnetic wave in visible as well as near infrared region. Four transition metal dichalcogenides are considered and found that most of these provide perfect absorbance for almost full considered wavelength range i.e. 200-1000 nm. Demonstrated results confirm the extended operating region and improved absorbance of the proposed absorber in comparison to the existing absorbers made of different materials. Further, absorber performance is improved by using thin layers of gold and chromium. Simple geometry of the proposed absorber also ensures easy fabrication.

  2. Arthroscopic Labral Base Repair in the Hip: 5-Year Minimum Clinical Outcomes.

    PubMed

    Domb, Benjamin G; Yuen, Leslie C; Ortiz-Declet, Victor; Litrenta, Jody; Perets, Itay; Chen, Austin W

    2017-10-01

    Arthroscopic labral base repair (LBR) in the hip is a previously described technique designed to restore the native functional anatomy of the labrum by reproducing its seal against the femoral head. LBR has been shown to have good short-term outcomes. Hypothesis/Purpose: The purpose was to evaluate clinical outcomes of an LBR cohort with a minimum 5-year follow-up. It was hypothesized that patients who underwent LBR would continue to have significant improvement from their preoperative scores and maintain scores similar to their 2-year outcomes. Case series; Level of evidence, 4. Data for patients undergoing primary hip arthroscopic surgery with LBR from February 2008 to May 2011 with a minimum 5-year follow-up were prospectively collected and retrospectively reviewed. Patients with preoperative Tonnis osteoarthritis grade ≥2, previous hip conditions (slipped capital femoral epiphysis, avascular necrosis, Legg-Calv-Perthes disease), severe dysplasia (lateral center-edge angle <18°), or previous ipsilateral hip surgery were excluded. Statistical equivalence tests evaluated patient-reported outcomes (PROs) including the modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), Hip Outcome Score-Sport-Specific Subscale (HOS-SSS), visual analog scale (VAS) for pain, and patient satisfaction (0-10 scale; 10 = very satisfied). Of the 70 patients (74 hips) who met inclusion and exclusion criteria, 60 (85.7%) patients (64 hips) were available at a minimum 5-year follow-up. All PRO scores significantly improved from preoperative values with a mean follow-up of 67.8 ± 7.4 months (range, 60.0-89.7 months). The mean mHHS increased from 64.4 ±13.8 to 85.3 ± 17.7 ( P < .001), the mean NAHS from 63.7 ± 17.0 to 87.0 ± 14.7 ( P < .001), and the mean HOS-SSS from 47.1 ± 23.2 to 76.5 ± 25.9 ( P < .001). The mean VAS score decreased from 5.9 ± 2.4 to 2.0 ± 2.1 ( P < .001). The mean patient satisfaction score was 8.1 ± 2.0. The improvement in PRO scores was

  3. Carbon Absorber Retrofit Equipment (CARE)

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Klein, Eric

    During Project DE-FE0007528, CARE (Carbon Absorber Retrofit Equipment), Neumann Systems Group (NSG) designed, installed and tested a 0.5MW NeuStream® carbon dioxide (CO 2) capture system using the patented NeuStream® absorber equipment and concentrated (6 molal) piperazine (PZ) as the solvent at Colorado Springs Utilities’ (CSU’s) Martin Drake pulverized coal (PC) power plant. The 36 month project included design, build and test phases. The 0.5MW NeuStream® CO 2 capture system was successfully tested on flue gas from both coal and natural gas combustion sources and was shown to meet project objectives. Ninety percent CO 2 removal was achieved with greater thanmore » 95% CO 2product purity. The absorbers tested support a 90% reduction in absorber volume compared to packed towers and with an absorber parasitic power of less than 1% when configured for operation with a 550MW coal plant. The preliminary techno-economic analysis (TEA) performed by the Energy and Environmental Research Center (EERC) predicted an over-the-fence cost of $25.73/tonne of CO 2 captured from a sub-critical PC plant.« less

  4. Characterization and device performance of (AgCu)(InGa)Se2 absorber layers

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Hanket, Gregory; Boyle, Jonathan H.; Shafarman, William N.

    The study of (AgCu)(InGa)Se2 absorber layers is of interest in that Ag-chalcopyrites exhibit both wider bandgaps and lower melting points than their Cu counterparts. (AgCu)(InGa)Se2 absorber layers were deposited over the composition range 0 < Ag/(Ag+Cu) < 1 and 0.3 < Ga/(In+Ga) < 1.0 using a variety of elemental co-evaporation processes. Films were found to be singlephase over the entire composition range, in contrast to prior studies. Devices with Ga content 0.3 < Ga/(In+Ga) <0.5 tolerated Ag incorporation up to Ag/(Ag+Cu) = 0.5 without appreciable performance loss. Ag-containing films with Ga/(In+Ga) = 0.8 showed improved device characteristics over Cu-only controlmore » samples, in particular a 30-40% increase in short-circuit current. An absorber layer with composition Ag/(Ag+Cu) = 0.75 and Ga/(In+Ga) = 0.8 yielded a device with VOC = 890 mV, JSC = 20.5mA/cm2, fill factor = 71.3%, and η = 13.0%.« less

  5. Transition metal atoms absorbed on MoS2/h-BN heterostructure: stable geometries, band structures and magnetic properties.

    PubMed

    Wu, Yanbing; Huang, Zongyu; Liu, Huating; He, Chaoyu; Xue, Lin; Qi, Xiang; Zhong, Jianxin

    2018-06-15

    We have studied the stable geometries, band structures and magnetic properties of transition-metal (V, Cr, Mn, Fe, Co and Ni) atoms absorbed on MoS2/h-BN heterostructure systems by first-principles calculations. By comparing the adsorption energies, we find that the adsorbed transition metal (TM) atoms prefer to stay on the top of Mo atoms. The results of the band structure without spin-orbit coupling (SOC) interaction indicate that the Cr-absorbed systems behave in a similar manner to metals, and the Co-absorbed system exhibits a half-metallic state. We also deduce that the V-, Mn-, Fe-absorbed systems are semiconductors with 100% spin polarization at the HOMO level. The Ni-absorbed system is a nonmagnetic semiconductor. In contrast, the Co-absorbed system exhibits metallic state, and the bandgap of V-absorbed system decreases slightly according to the SOC calculations. In addition, the magnetic moments of all the six TM atoms absorbed on the MoS2/h-BN heterostructure systems decrease when compared with those of their free-standing states.

  6. Outcomes of a New Residential Scheme for Adults with Intellectual Disabilities in Taiwan: A 2-Year Follow-Up

    ERIC Educational Resources Information Center

    Chou, Y-C.; Pu, C.; Kroger, T.; Lee, W.; Chang, S.

    2011-01-01

    Background: The Taiwanese government launched a new programme in November 2004 to support adults with intellectual disabilities living in smaller facilities. This paper aims to evaluate the service outcomes of this new residential scheme over 2 years including those residents who moved from an institution and those who moved from their family.…

  7. Clinical Outcomes of Hip Arthroscopy in Patients 60 or Older: A Minimum of 2-Year Follow-up.

    PubMed

    Capogna, Brian M; Ryan, Michael K; Begly, John P; Chenard, Kristofer E; Mahure, Siddharth A; Youm, Thomas

    2016-12-01

    To examine clinical outcomes and survivorship in patients aged 60 years or older who underwent hip arthroscopy for management of hip pain. Prospectively collected data for patients 60 or older undergoing hip arthroscopy were obtained. All patients were indicated for hip arthroscopy based on standard preoperative examination as well as routine and advanced imaging. Demographic data, diagnosis, and details regarding operative procedures were collected. Baseline preoperative modified Harris Hip Scores (mHHS) and Non-arthritic Hip Scores (NAHS) were compared to mHHS and NAHS at the 2-year follow-up. Survivorship was assessed to determine failure rates, with failure defined as any subsequent ipsilateral revision arthroscopic surgery and/or hip arthroplasty. Forty-two patients met inclusion criteria. Mean age (standard deviation) and body mass index were 65.8 years (4.5 years) and 26.1 (4.7), respectively. Baseline mean mHHS and NAHS for all patients improved from 47.8 (±12.5) and 47.3 (±13.6) to 75.6 (±17.6) and 78.3 (±18.6), respectively (P < .001 for both). Five patients (11.9%) met failure criteria and underwent additional surgery at an average of 14.8 (8-30) months. Three underwent conversion to total hip arthroplasty (7.1%), whereas 2 had revision arthroscopy with cam/pincer resection and labral repair for recurrent symptoms (4.7%). One- and 2-year survival rates were 95.2% and 88.9%, respectively. Our results suggest that in patients 60 or older with Tonnis grade 0 or 1 osteoarthritic changes on initial radiographs-treatment with hip arthroscopy can lead to reliable improvement in early outcomes. As use of hip arthroscopy for treatment of mechanical hip pain increases, additional studies with long-term follow-up are needed. Level IV, therapeutic case series. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  8. Reflection measurements of microwave absorbers

    NASA Astrophysics Data System (ADS)

    Baker, Dirk E.; van der Neut, Cornelis A.

    1988-12-01

    A swept-frequency interferometer is described for making rapid, real-time assessments of localized inhomogeneities in planar microwave absorber panels. An aperture-matched exponential horn is used to reduce residual reflections in the system to about -37 dB. This residual reflection is adequate for making comparative measurements on planar absorber panels whose reflectivities usually fall in the -15 to -25 dB range. Reflectivity measurements on a variety of planar absorber panels show that multilayer Jaumann absorbers have the greatest inhomogeneity, while honeycomb absorbers generally have excellent homogeneity within a sheet and from sheet to sheet. The test setup is also used to measure the center frequencies of resonant absorbers. With directional couplers and aperture-matched exponential horns, the technique can be easily applied in the standard 2 to 40 GHz waveguide bands.

  9. Outcome of children older than one year with neuroblastoma.

    PubMed

    Fayea, Najwa Y; Atra, Ayad A; Khattab, Taha; Elimam, Najla A; Felimban, Sami; Yousef, Abdelmoutaleb; Basheer, Ahmed; Zayed, Abdullah; Baothman, Abdullah; Al-Sheikh, Nada; Hussen, Wafa

    2008-01-01

    To assess the outcome of children older than one year with neuroblastoma treated at King Abdul-Aziz Medical City, Jeddah, Kingdom of Saudi Arabia. We retrospectively reviewed the files of 52 children older than one year with neuroblastoma (NBL) treated at our center between September 1987 and May 2003. Treatment consisted of OPEC chemotherapy regimen (vincristine, cisplatin, etoposide, and cyclophosphamide) or alternating OPEC/OJEC (carboplatin in place of cisplatin), surgical resection +/- radiotherapy (RT). No patient received high dose therapy (HDT). Thirty-four patients (65%) were stage 4, 12 (23%) stage 3, and 6 (11%) stage 2. Three stage 2 patients were treated with surgery only, all are alive in complete remission (CR). All stage 3 and 4 patients were treated with chemotherapy and surgery +/- RT. After induction chemotherapy, CR was achieved in 17 patients (32%) and partial remission in 10 (19%). Complete surgical resection was possible in 11 patients (22%). Disease recurrence or progression occurred in 27 patients (51%). With a median follow-up of 24 months (range 4-120), the 2-year event free survival was 10%, 82%, and 87% and the overall survival was 12%, 83%, and 100% for stage 4, 3, and 2. Children older than one year with localized NBL have good prognosis compared to those with stage 4. The use of HDT may improve the outcome in the latter group. Toxicity was significant, and adoption of risk-stratified treatment may help to reduce treatment complications.

  10. Pelvic trauma with displaced sacral fractures: functional outcome at one year.

    PubMed

    Tötterman, Anna; Glott, Thomas; Søberg, Helene Lundgaard; Madsen, Jan Erik; Røise, Olav

    2007-06-01

    A prospective single-cohort study of 31 patients surgically treated for pelvic injuries with displaced sacral fractures. To describe the medium term functional outcome in unstable sacral fractures. Displaced sacral fractures pose a special challenge in orthopedic surgery due to the high rate of associated injuries. Little information is available on the medium-term functional outcome of patients with injuries which include unstable sacral fractures. We examined 31 patients with displaced sacral fractures having 10 mm or more displacement, 1 year (mean, 1.4 years; range, 1.0-2.5 years) after injury. Data from a previous study were supplemented with functional outcome measures (work status, independence in ADL, and SF-36). An association between outcome and tested variables was sought. Fifteen months after injury, 65% of the patients had regained their independence in functions pertaining to daily activities; 33% had returned to work. All dimensions of perceived health were affected. Polytrauma and impairments relative to voiding and sexual function had a detrimental effect on outcome. Fracture characteristics were not predictive of poor outcome. Although the majority of patients achieved independent living, medium-term follow-up indicated significant residual disability. The complex nature of these fractures and the associated injuries should be considered in the rehabilitation of these patients.

  11. Functional and motor outcome 5 years after stroke is equivalent to outcome at 2 months: follow-up of the collaborative evaluation of rehabilitation in stroke across Europe.

    PubMed

    Meyer, Sarah; Verheyden, Geert; Brinkmann, Nadine; Dejaeger, Eddy; De Weerdt, Willy; Feys, Hilde; Gantenbein, Andreas R; Jenni, Walter; Laenen, Annouschka; Lincoln, Nadina; Putman, Koen; Schuback, Birgit; Schupp, Wilfried; Thijs, Vincent; De Wit, Liesbet

    2015-06-01

    Recovery of patients within the first 6 months after stroke is well documented, but there has been little research on long-term recovery. The aim of this study was to analyze functional and motor recovery between admission to rehabilitation centres and 5 years after stroke. This follow-up of the Collaborative Evaluation of Rehabilitation in Stroke Across Europe study, included patients from 4 European rehabilitation centres. Patients were assessed on admission, at 2 and 6 months, and 5 years after stroke, using the Barthel Index, Rivermead Motor Assessment Gross Function, Leg and Trunk function, and Arm function. Linear mixed models were used, corrected for baseline characteristics. To account for the drop-out during follow-up, the analysis is likelihood-based (assumption of missingness at random). A total of 532 patients were included in this study, of which 238 were followed up at 5 years post stroke. Mean age at stroke onset was 69 (±10 SD) years, 53% were men, 84% had ischemic strokes, and 53% had left-sided motor impairment. Linear mixed model analysis revealed a significant deterioration for all 4 outcomes between 6 months and 5 years (P<0.0001). Scores at 2 months were not statistically significant different from scores at 5 years after stroke. Higher age (P<0.0001) and increasing stroke severity on admission (P<0.0001) negatively affected long-term functional and motor recovery. Five-year follow-up revealed deterioration in functional and motor outcome, with a return to the level measured at 2 months. Increasing age and increasing stroke severity negatively affected recovery up to 5 years after stroke. © 2015 American Heart Association, Inc.

  12. How Satisfied Are Patients with Arthroscopic Bankart Repair? A 2-Year Follow-up on Quality-of-Life Outcome.

    PubMed

    Saier, Tim; Plath, Johannes E; Waibel, Sabrina; Minzlaff, Philipp; Feucht, Matthias J; Herschbach, Peter; Imhoff, Andreas B; Braun, Sepp

    2017-10-01

    To report general life and health satisfaction after arthroscopic Bankart repair in patients with post-traumatic recurrent anterior glenohumeral instability and to investigate postoperative time lost to return to work at 2-year follow-up. Between 2011 and 2013 patients treated with arthroscopic Bankart repair in the beach chair position for acute shoulder instability were included in this study. Questions on Life Satisfaction Modules (FLZ M ) and the Short Form 12 (SF-12) were used as quality-of-life outcome scales. Oxford Instability Score (OIS), Quick Disabilities of the Arm, Shoulder and Hand questionnaire (QuickDASH), and self-reported American Shoulder and Elbow Surgeons (ASES) shoulder index were used as functional outcome scales. Return to work (months) was monitored and analyzed depending on physical workload. Data were assessed the day before surgery and prospectively monitored until 24 months postoperatively. Quality-of-life outcome was correlated with functional shoulder outcome and compared with normative age-adjusted data. Paired t-test, Wilcoxon test, Mann-Whitney U-Test, and Spearman's correlation coefficient were used for statistical analysis. Fifty-three patients were prospectively included. The mean age at surgery was 29.4 years. Satisfaction with general life and satisfaction with health (FLZ M ) as well as physical component scale (SF-12) improved significantly to values above normative data within 6 to 12 months after surgery (each P < .001). OIS, QuickDASH, and ASES improved significantly from baseline until 24 months after surgery (each P < .001). For ASES, improvement above minimal clinically important difference was shown. There was a positive correlation between quality of life and functional outcome scores (P < .05; rho, 0.3-0.4). Mean time to return to work was 2 months (range, 0-10; standard deviation, 1.9), with significantly longer time intervals observed in patients with heavy physical workload (3.1 months; range, 0 to 10

  13. Weight and Metabolic Outcomes After 2 Years on a Low-Carbohydrate Versus Low-Fat Diet

    PubMed Central

    Foster, Gary D.; Wyatt, Holly R.; Hill, James O.; Makris, Angela P.; Rosenbaum, Diane L.; Brill, Carrie; Stein, Richard I.; Mohammed, B. Selma; Miller, Bernard; Rader, Daniel J.; Zemel, Babette; Wadden, Thomas A.; Tenhave, Thomas; Newcomb, Craig W.; Klein, Samuel

    2010-01-01

    Background Previous studies comparing low-carbohydrate and low-fat diets have not included a comprehensive behavioral treatment, resulting in suboptimal weight loss. Objective To evaluate the effects of 2-year treatment with a low-carbohydrate or low-fat diet, each of which was combined with a comprehensive lifestyle modification program. Design Randomized parallel-group trial. (ClinicalTrials.gov registration number: NCT00143936) Setting 3 academic medical centers. Patients 307 participants with a mean age of 45.5 years (SD, 9.7 years) and mean body mass index of 36.1 kg/m2 (SD, 3.5 kg/m2). Intervention A low-carbohydrate diet, which consisted of limited carbohydrate intake (20 g/d for 3 months) in the form of low–glycemic index vegetables with unrestricted consumption of fat and protein. After 3 months, participants in the low-carbohydrate diet group increased their carbohydrate intake (5 g/d per wk) until a stable and desired weight was achieved. A low-fat diet consisted of limited energy intake (1200 to 1800 kcal/d; ≤30% calories from fat). Both diets were combined with comprehensive behavioral treatment. Measurements Weight at 2 years was the primary outcome. Secondary measures included weight at 3, 6, and 12 months and serum lipid concentrations, blood pressure, urinary ketones, symptoms, bone mineral density, and body composition throughout the study. Results Weight loss was approximately 11 kg (11%) at 1 year and 7 kg (7%) at 2 years. There were no differences in weight, body composition, or bone mineral density between the groups at any time point. During the first 6 months, the low-carbohydrate diet group had greater reductions in diastolic blood pressure, triglyceride levels, and very-low-density lipoprotein cholesterol levels, lesser reductions in low-density lipoprotein cholesterol levels, and more adverse symptoms than did the low-fat diet group. The low-carbohydrate diet group had greater increases in high-density lipoprotein cholesterol levels

  14. The predictive value of 2-year posttreatment biopsy after prostate cancer radiotherapy for eventual biochemical outcome

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Vance, Waseet; Tucker, Susan L.; Crevoisier, Renaud de

    2007-03-01

    Purpose: To determine the value of a 2-year post-radiotherapy (RT) prostate biopsy for predicting eventual biochemical failure in patients who were treated for localized prostate cancer. Methods and Materials: This study comprised 164 patients who underwent a planned 2-year post-RT prostate biopsy. The independent prognostic value of the biopsy results for forecasting eventual biochemical outcome and overall survival was tested with other factors (the Gleason score, 1992 American Joint Committee on Cancer tumor stage, pretreatment prostate-specific antigen level, risk group, and RT dose) in a multivariate analysis. The current nadir + 2 (CN + 2) definition of biochemical failure wasmore » used. Patients with rising prostate-specific antigen (PSA) or suspicious digital rectal examination before the biopsy were excluded. Results: The biopsy results were normal in 78 patients, scant atypical and malignant cells in 30, carcinoma with treatment effect in 43, and carcinoma without treatment effect in 13. Using the CN + 2 definition, we found a significant association between biopsy results and eventual biochemical failure. We also found that the biopsy status provides predictive information independent of the PSA status at the time of biopsy. Conclusion: A 2-year post-RT prostate biopsy may be useful for forecasting CN + 2 biochemical failure. Posttreatment prostate biopsy may be useful for identifying patients for aggressive salvage therapy.« less

  15. Analyses of outcomes of one-stage operation for treatment of late-diagnosed developmental dislocation of the hip: 864 hips followed for 3.2 to 8.9 years.

    PubMed

    Ning, Bo; Yuan, Yi; Yao, Jie; Zhang, Sichng; Sun, Jun

    2014-11-28

    The one-stage procedure for treatment of older developmental dislocation of the hip (DDH) is used widely. However, the best age group for this operation is still unknown. The aims of our study were to evaluate middle-term outcomes of one-stage surgical treatment of a large number of patients with late-diagnosed DDH, and to explore the best age group for treatment. We retrospectively reviewed 652 patients with a total of 864 hip joints with DDH, all aged >18 months. All the hip joints were treated with one-stage procedures including open reduction, pelvic osteotomy, and femoral shortening. The patients were divided into three groups according to age at surgery: Group I: 1.5-2.5 years; Group II: 2.5-8 years; and Group III: >8 years. The latest clinical and radiographic outcomes, complications and avascular necrosis (AVN) of the femoral head were evaluated and compared among the three groups. The mean age at surgery was 5.8 years (range: 1.5-13.2 years). The average time of follow-up was 6.2 years (range: 3.2-8.9 years). A total of 79.4% of good or excellent outcomes were obtained for clinical functional evaluation according to the McKay classification. For radiographic outcomes, 732 hips (84.7%) were classified as good or excellent according to the Severin classification. A total of 27.4% of all hips had a poor outcome according to the Kalamchi and MacEwen classification for AVN. The poorest outcomes were observed for clinical, radiographic and AVN results in Group III (p < 0.001). Compared with Group I, the better results for clinical and AVN outcomes were found in Group II (p < 0.001). However, similar clinical outcomes were observed between Groups I and II (p > 0.05). A significantly higher incidence of redislocation and residual acetabular dysplasia was observed in Tonnis grade II and III hip dislocation (p < 0.001). One-stage treatment of late-diagnosed DDH had a good outcome in young and middle group. Younger patients achieved better results

  16. Anterior Cervical Discectomy and Fusion Outcomes over 10 Years: A Prospective Study.

    PubMed

    Buttermann, Glenn R

    2018-02-01

    Prospective cohort study with >10-year follow-up. To assess the long-term, >10-year clinical outcomes of anterior cervical discectomy and fusion (ACDF) and to compare outcomes based on primary diagnosis of disc herniation, stenosis or advanced degenerative disc disease (DDD), number of levels treated, and preexisting adjacent level degeneration. ACDF is a proven treatment for patients with stenosis and disc herniation and results in significantly improved short- and intermediate-term outcomes. Motion preservation treatments may result in improved long-term outcomes but need to be compared to long-term ACDF outcomes reference. Patients who had disc herniation, stenosis, and DDD and underwent ACDF with or without decompression were prospectively enrolled and followed for a minimum of 10 years with outcome assessment at various intervals. All 159 consecutive patients had autogenous tricortical iliac crest bone graft and plate instrumentation used. Outcomes included visual analog scale for neck and arm pain. pain drawing, Oswestry Disability Index, and self-assessment of procedure success. Preoperative adjacent-level disc degeneration, pseudarthrosis, and secondary operations were analyzed. For all diagnostic groups, significant outcomes improvement was seen at all follow-up periods for all scales relative to preoperative scores. Outcomes were not related to age, gender, number of levels treated, and minimally to preexisting degeneration at the adjacent level. The use of narcotic pain medication decreased substantially. Neurological deficits almost all resolved. Patient self-reported success ranged from 85% to 95%. Over the long term, additional surgery for pseudarthrosis (10%) occurred in the early follow-up period, and for adjacent segment degeneration (21%), which occurred linearly during the >10-year follow-up period. ACDF leads to significantly improved outcomes for all primary diagnoses and was sustained for >10 years' follow-up. Secondary surgeries were

  17. Interspecific interactions through 2 million years: are competitive outcomes predictable?

    PubMed Central

    Di Martino, Emanuela; Rust, Seabourne

    2016-01-01

    Ecological interactions affect the survival and reproduction of individuals. However, ecological interactions are notoriously difficult to measure in extinct populations, hindering our understanding of how the outcomes of interactions such as competition vary in time and influence long-term evolutionary changes. Here, the outcomes of spatial competition in a temporally continuous community over evolutionary timescales are presented for the first time. Our research domain is encrusting cheilostome bryozoans from the Wanganui Basin of New Zealand over a ca 2 Myr time period (Pleistocene to Recent). We find that a subset of species can be identified as consistent winners, and others as consistent losers, in the sense that they win or lose interspecific competitive encounters statistically more often than the null hypothesis of 50%. Most species do not improve or worsen in their competitive abilities through the 2 Myr period, but a minority of species are winners in some intervals and losers in others. We found that conspecifics tend to cluster spatially and interact more often than expected under a null hypothesis: most of these are stand-off interactions where the two colonies involved stopped growing at edges of encounter. Counterintuitively, competitive ability has no bearing on ecological dominance. PMID:27581885

  18. Return to Sport and Clinical Outcomes After Hip Arthroscopic Labral Repair in Young Amateur Athletes: Minimum 2-Year Follow-Up.

    PubMed

    Mohan, Rohith; Johnson, Nick R; Hevesi, Mario; Gibbs, Christopher M; Levy, Bruce A; Krych, Aaron J

    2017-09-01

    To determine the rate of return of young amateur athletes to sport after hip arthroscopy, their clinical outcomes, and pathologic risk factors for worse outcomes 2 years after surgery. This study included all patients between age 13 and 23 who participated in a sport prior to surgery with intent to return who underwent hip arthroscopy after failure of comprehensive nonoperative management for whom 2-year outcome scores were available. Outcomes collected retrospectively included modified Harris Hip Score (mHHS) and the Hip Outcome Scores (HOS) subscales for activities of daily living (ADL) and sport (HOS Sport). In addition, sport played, return to sport rates, and Tegner Scores were measured preinjury and postoperatively. Descriptive statistics were used to present demographic data. A priori analysis was used to determine the sample size needed to show minimal clinically important differences for mHHS, HOS ADL, and HOS Sport. The study population included 50 patients with a mean age of 17.8 years. Athletes returned to sport at a rate of 92% (46/50). At a mean follow-up of 34 months, the mean mHHS, HOS ADL, and HOS Sport outcome scores were 85, 91, and 80 for the entire study group; 87, 92, and 84 for the group that returned to sport; and 67, 82, and 41 for the group that did not return to sport, respectively. Median preinjury and postoperative Tegner levels were 8 and 7, respectively. Labral takedown and reattachment was associated with lower HOS ADL (P = .01) and HOS Sport scores (P = .02). Athletes returned to sport at a high rate (92%; 46/50) after hip arthroscopy and perform activities at near preinjury levels. In this group of athletes, arthroscopic labral repair with chondrolabral preservation, which reflected less severe chondrolabral pathology, performed better than labral repair with takedown and reattachment. Level IV, therapeutic case series. Copyright © 2017 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  19. On the incidence of Mg II absorbers along the blazar sightlines

    NASA Astrophysics Data System (ADS)

    Mishra, S.; Chand, H.; Krishna, Gopal-; Joshi, R.; Shchekinov, Y. A.; Fatkhullin, T. A.

    2018-02-01

    It is widely believed that the cool gas clouds traced by Mg II absorption, within a velocity offset of 5000 km s-1 relative to the background quasar are mostly associated with the quasar itself, whereas the absorbers seen at larger velocity offsets towards us are intervening absorber systems and hence their existence is completely independent of the background quasar. Recent evidence by Bergeron et al. (hereinafter BBM) has seriously questioned this paradigm, by showing that the number density of intervening Mg II absorbers towards the 45 blazars in their sample is nearly two times the expectation based on the Mg II absorption systems seen towards normal quasars (QSOs). Given its serious implications, it becomes important to revisit this finding, by enlarging the blazar sample and subjecting it to an independent analysis. Here, we first report the outcome of our re-analysis of the available spectroscopic data for the BBM sample itself. Our analysis of the BBM sample reproduces their claimed factor of 2 excess of dN/dz along blazar sightlines, vis-à-vis normal QSOs. We have also assembled an approxmately three times larger sample of blazars, albeit with moderately sensitive optical spectra. Using this sample together with the BBM sample, our analysis shows that the dN/dz of the Mg II absorbers statistically matches that known for normal QSO sightlines. Further, the analysis indicates that associated absorbers might be contributing significantly to the estimated dN/dz up to offset speeds Δv ∼ 0.2c relative to the blazar.

  20. Absorbed dose thresholds and absorbed dose rate limitations for studies of electron radiation effects on polyetherimides

    NASA Technical Reports Server (NTRS)

    Long, Edward R., Jr.; Long, Sheila Ann T.; Gray, Stephanie L.; Collins, William D.

    1989-01-01

    The threshold values of total absorbed dose for causing changes in tensile properties of a polyetherimide film and the limitations of the absorbed dose rate for accelerated-exposure evaluation of the effects of electron radiation in geosynchronous orbit were studied. Total absorbed doses from 1 kGy to 100 MGy and absorbed dose rates from 0.01 MGy/hr to 100 MGy/hr were investigated, where 1 Gy equals 100 rads. Total doses less than 2.5 MGy did not significantly change the tensile properties of the film whereas doses higher than 2.5 MGy significantly reduced elongation-to-failure. There was no measurable effect of the dose rate on the tensile properties for accelerated electron exposures.

  1. Student and community outcomes in service-learning: part 2--community outcomes.

    PubMed

    Reising, Deanna L; Allen, Patricia N; Hall, Susan G

    2006-12-01

    This article is the second of a two-part series reporting outcomes from a service-learning program implemented in a bachelor of science in nursing program. Part 1 (on pages 512-515) described students' perceptions of outcomes realized from the program, and Part 2 describes the community outcomes. The purposes of the program were to provide students with history-taking, blood pressure, and heart rate assessment skills, and beginning counseling skills, as well as to provide the university community with blood pressure screening and counseling in a convenient and accessible location. Data on community outcomes were collected on a continual basis during the hypertension screening and counseling program implementation. Clients were anonymously surveyed on health behavior actions taken after their screening and on the screening process. More than 700 client screenings were performed over 2 years, with positive health behavior changes being reported by clients.

  2. Scattering Properties of Heterogeneous Mineral Particles with Absorbing Inclusions

    NASA Technical Reports Server (NTRS)

    Dlugach, Janna M.; Mishchenko, Michael I.

    2015-01-01

    We analyze the results of numerically exact computer modeling of scattering and absorption properties of randomly oriented poly-disperse heterogeneous particles obtained by placing microscopic absorbing grains randomly on the surfaces of much larger spherical mineral hosts or by imbedding them randomly inside the hosts. These computations are paralleled by those for heterogeneous particles obtained by fully encapsulating fractal-like absorbing clusters in the mineral hosts. All computations are performed using the superposition T-matrix method. In the case of randomly distributed inclusions, the results are compared with the outcome of Lorenz-Mie computations for an external mixture of the mineral hosts and absorbing grains. We conclude that internal aggregation can affect strongly both the integral radiometric and differential scattering characteristics of the heterogeneous particle mixtures.

  3. Preterm premature rupture of membranes at 22-25 weeks' gestation: perinatal and 2-year outcomes within a national population-based study (EPIPAGE-2).

    PubMed

    Lorthe, Elsa; Torchin, Héloïse; Delorme, Pierre; Ancel, Pierre-Yves; Marchand-Martin, Laetitia; Foix-L'helias, Laurence; Benhammou, Valérie; Gire, Catherine; D'Ercole, Claude; Winer, Norbert; Sentilhes, Loïc; Subtil, Damien; Goffinet, François; Kayem, Gilles

    2018-05-28

    Most clinical guidelines state that with early preterm premature rupture of membranes, obstetric and pediatric teams must share a realistic and individualized appraisal of neonatal outcomes with parents and consider their wishes for all decisions. However, we currently lack reliable and relevant data, according to gestational age at rupture of membranes, to adequately counsel parents during pregnancy and to reflect on our policies of care at these extreme gestational ages. To describe both perinatal and 2-year outcomes of preterm infants born after preterm premature rupture of membranes at 22-25 weeks' gestation. EPIPAGE-2 is a French national prospective population-based cohort of preterm infants born in 546 maternity units in 2011. Inclusion criteria in this analysis were women diagnosed with preterm premature rupture of membranes at 22-25 weeks' gestation and singleton or twin gestations with fetus(es) alive at rupture of membranes. Latency duration, antenatal management, and outcomes (survival at discharge, survival at discharge without severe morbidity, and survival at 2 years' corrected age without cerebral palsy) were described and compared by gestational age at preterm premature rupture of membranes. Among the 1435 women with a diagnosis of preterm premature rupture of membranes, 379 were at 22-25 weeks' gestation, with 427 fetuses (331 singletons and 96 twins). Median GA at preterm premature rupture of membranes and at birth were 24 (interquartile range 23-25) and 25 (24-27) weeks, respectively. For each gestational age at preterm premature rupture of membranes, nearly half of the fetuses were born within the week after the rupture of membranes. Among the 427 fetuses, 51.7% were survivors at discharge (14.1%, 39.5%, 66.8% and 75.8% with preterm premature rupture of membranes at 22, 23, 24 and 25 weeks, respectively), 38.8% were survivors at discharge without severe morbidity and 46.4% were survivors at 2 years without cerebral palsy, with wide variations

  4. The Ahmed Versus Baerveldt study: one-year treatment outcomes.

    PubMed

    Christakis, Panos G; Kalenak, Jeffrey W; Zurakowski, David; Tsai, James C; Kammer, Jeffrey A; Harasymowycz, Paul J; Ahmed, Iqbal I K

    2011-11-01

    To report the 1-year treatment outcomes of the Ahmed Versus Baerveldt (AVB) Study. Multicenter randomized clinical trial. A total of 238 patients were enrolled in the study, including 124 in the Ahmed group and 114 in the Baerveldt group. Patients aged 18 years or older with uncontrolled glaucoma refractory to medicinal, laser, and surgical therapy were randomized to undergo implantation of an Ahmed-FP7 valve (New World Medical, Inc., Rancho Cucamonga, CA) or a Baerveldt-350 implant (Abbott Medical Optics, Inc., Santa Ana, CA), to be followed for 5 years. The primary outcome measure was failure, defined as intraocular pressure (IOP) out of target range (5-18 mmHg with ≥ 20% reduction from baseline) for 2 consecutive visits after 3 months, vision-threatening complications, additional glaucoma procedures, or loss of light perception. Secondary outcome measures included IOP, medication use, visual acuity, complications, and interventions. There were no significant differences in baseline ocular or demographic characteristics between the study groups with the exception of sex. Preoperatively, the study group had a mean IOP of 31.4 ± 10.8 mmHg on a mean of 3.1 ± 1.0 glaucoma medications with a median Snellen acuity of 20/100. The cumulative probability of failure a 1-year was 43% in the Ahmed group and 28% in the Baerveldt group (P = 0.02). The mean IOP at 1 year was 16.5 ± 5.3 mmHg in the Ahmed group and 13.6 ± 4.8 mmHg in the Baerveldt group (P < 0.001). The mean number of glaucoma medications required was 1.6 ± 1.3 in the Ahmed group and 1.2 ± 1.3 in the Baerveldt group (P = 0.03). Visual acuity was similar in both groups at all visits in the first year (P = 0.66). In the first year after surgery, there were a similar number of patients who experienced postoperative complications in the 2 groups (45% Ahmed, 54% Baerveldt, P = 0.19), but a greater number of patients in the Baerveldt group required interventions (26% Ahmed vs. 42% Baerveldt, P = 0.009). The

  5. Commander Lousma stows trash bags in middeck CO2 Absorber Stowage volume

    NASA Technical Reports Server (NTRS)

    1982-01-01

    Commander Lousma uses his body as a zero gravity garbage compactor to stow plastic bags full of empty containers and trash in the Carbon Dioxide (CO2) Absorber Stowage volume in front of the airlock hatch.

  6. Outcomes of a new residential scheme for adults with intellectual disabilities in Taiwan: a 2-year follow-up.

    PubMed

    Chou, Y-C; Pu, C; Kröger, T; Lee, W; Chang, S

    2011-09-01

    The Taiwanese government launched a new programme in November 2004 to support adults with intellectual disabilities living in smaller facilities. This paper aims to evaluate the service outcomes of this new residential scheme over 2 years including those residents who moved from an institution and those who moved from their family. A one-group repeated-measures analysis was conducted for five interviews after the adults with intellectual disabilities entered the new environment. Forty-nine adults were initially studied (T1) and 29 adults remained in the homes until the end of the study (T5). This study found significant improvements over the 2 years in the residents' quality of life and family contact. The results also highlight a decrease in maladaptive behaviour among the residents moving from institution and an increase in choice making and family contact among the residents moving from family. No significant changes in adaptive behaviour and community inclusion were found. Results revealed that further policy changes and financial support including service quality assurance are required in order to improve service outcomes for adults living in the new residential scheme. © 2011 The Authors. Journal of Intellectual Disability Research © 2011 Blackwell Publishing Ltd.

  7. ABSORB II randomized controlled trial: a clinical evaluation to compare the safety, efficacy, and performance of the Absorb everolimus-eluting bioresorbable vascular scaffold system against the XIENCE everolimus-eluting coronary stent system in the treatment of subjects with ischemic heart disease caused by de novo native coronary artery lesions: rationale and study design.

    PubMed

    Diletti, Roberto; Serruys, Patrick W; Farooq, Vasim; Sudhir, Krishnankutty; Dorange, Cecile; Miquel-Hebert, Karine; Veldhof, Susan; Rapoza, Richard; Onuma, Yoshinobu; Garcia-Garcia, Hector M; Chevalier, Bernard

    2012-11-01

    Currently, no data are available on the direct comparison between the Absorb everolimus-eluting bioresorbable vascular scaffold (Absorb BVS) and conventional metallic drug-eluting stents. The ABSORB II study is a randomized, active-controlled, single-blinded, multicenter clinical trial aiming to compare the second-generation Absorb BVS with the XIENCE everolimus-eluting metallic stent. Approximately 501 subjects will be enrolled on a 2:1 randomization basis (Absorb BVS/XIENCE stent) in approximately 40 investigational sites across Europe and New Zealand. Treated lesions will be up to 2 de novo native coronary artery lesions, each located in different major epicardial vessels, all with an angiographic maximal luminal diameter between 2.25 and 3.8 mm as estimated by online quantitative coronary angiography (QCA) and a lesion length of ≤48 mm. Clinical follow-up is planned at 30 and 180 days and at 1, 2, and 3 years. All subjects will undergo coronary angiography, intravascular ultrasound (IVUS) and IVUS-virtual histology at baseline (pre-device and post-device implantation) and at 2-year angiographic follow-up. The primary end point is superiority of the Absorb BVS vs XIENCE stent in terms of vasomotor reactivity of the treated segment at 2 years, defined as the QCA quantified change in the mean lumen diameter prenitrate and postnitrate administration. The coprimary end point is the noninferiority (reflex to superiority) of the QCA-derived minimum lumen diameter at 2 years postnitrate minus minimum lumen diameter postprocedure postnitrate by QCA. In addition, all subjects allocated to the Absorb BVS group will undergo multislice computed tomography imaging at 3 years. The ABSORB II randomized controlled trial (ClinicalTrials.gov NCT01425281) is designed to compare the safety, efficacy, and performance of Absorb BVS against the XIENCE everolimus-eluting stent in the treatment of de novo native coronary artery lesions. Copyright © 2012 Mosby, Inc. All rights

  8. Clinical and Aesthetic Outcome with Post-Extractive Implants with or without Soft Tissue Augmentation: A 2-Year Randomized Clinical Trial.

    PubMed

    Migliorati, Marco; Amorfini, Leonardo; Signori, Alessio; Biavati, Armando Silvestrini; Benedicenti, Stefano

    2015-10-01

    The aesthetic outcome of an implant-supported restoration is first of all dependent on the soft tissue volume. Because the labial bone plate resorbs in every direction after tooth extraction, even when an implant is placed immediately, most patients end up with compromised aesthetics. In this parallel-designed, randomized clinical trial, participants were randomly assigned to the test group (immediate load post-extractive implant treated with subepithelial connective tissue graft placed using the tunnel technique in the labial area) and control group (immediate load post-extractive implant treated without raising a flap) with an allocation ratio of 1:1. Both groups received deproteinized bovine bone mineral. Patients were observed at baseline, crown insertion, 1-year follow-up, and 2-year follow-up. Clinical, radiological and aesthetic parameters were recorded to assess primary treatment outcomes. A random permuted block system was blindly generated ensuring uniformity of the patient allocation during the trial by randomly distributing three participants to the test and three participants to the control group every six treated patients. At the 2-year examination, all 47 implants were successfully integrated, demonstrating stability and healthy peri-implant soft tissues as documented by standard clinical parameters. The results showed a soft tissue remodeling of -10% in thickness and -18% in highness in the non-grafted group, whereas in the grafted group there was a gain of 35% in thickness and a slight reduction of -11% in highness. Test group reported an increase of aesthetic result (mean pink aesthetic score [PES] 8) compared with control group (mean PES 6.65). This prospective study demonstrates the effectiveness of placing a soft tissue graft at the time of immediate implant placement in the aesthetic zone. At the 2-year follow-up, test group revealed a better aesthetic outcomes and stable facial soft tissues compared with control group. © 2013 Wiley

  9. The 2-Year Cosmetic Outcome of a Randomized Trial Comparing Prone and Supine Whole-Breast Irradiation in Large-Breasted Women

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Veldeman, Liv, E-mail: liv.veldeman@uzgent.be; Department of Radiotherapy and Experimental Cancer Research, Ghent University, Ghent; Schiettecatte, Kimberly

    Purpose: To report the 2-year cosmetic outcome of a randomized trial comparing prone and supine whole-breast irradiation in large-breasted patients. Methods and Materials: One hundred patients with a (European) cup size ≥C were included. Before and 2 years after radiation therapy, clinical endpoints were scored and digital photographs were taken with the arms alongside the body and with the arms elevated 180°. Three observers rated the photographs using the 4-point Harvard cosmesis scale. Cosmesis was also evaluated with the commercially available Breast Cancer Conservation Treatment.cosmetic results (BCCT.core) software. Results: Two-year follow-up data and photographs were available for 94 patients (47 supine treatedmore » and 47 prone treated). Patient and treatment characteristics were not significantly different between the 2 cohorts. A worsening of color change occurred more frequently in the supine than in the prone cohort (19/46 vs 10/46 patients, respectively, P=.04). Five patients in the prone group (11%) and 12 patients in the supine group (26%) presented with a worse scoring of edema at 2-year follow-up (P=.06). For retraction and fibrosis, no significant differences were found between the 2 cohorts, although scores were generally worse in the supine cohort. The cosmetic scoring by 3 observers did not reveal differences between the prone and supine groups. On the photographs with the hands up, 7 patients in the supine group versus none in the prone group had a worsening of cosmesis of 2 categories using the (BCCT.org) software (P=.02). Conclusion: With a limited follow-up of 2 years, better cosmetic outcome was observed in prone-treated than in supine-treated patients.« less

  10. Gastroschisis: one year outcomes from national cohort study.

    PubMed

    Bradnock, Timothy J; Marven, Sean; Owen, Anthony; Johnson, Paul; Kurinczuk, Jennifer J; Spark, Patsy; Draper, Elizabeth S; Knight, Marian

    2011-11-15

    To describe one year outcomes for a national cohort of infants with gastroschisis. Population based cohort study of all liveborn infants with gastroschisis born in the United Kingdom and Ireland from October 2006 to March 2008. All 28 paediatric surgical centres in the UK and Ireland. 301 infants (77%) from an original cohort of 393. Duration of parenteral nutrition and stay in hospital; time to establish full enteral feeding; rates of intestinal failure, liver disease associated with intestinal failure, unplanned reoperation; case fatality. Compared with infants with simple gastroschisis (intact, uncompromised, continuous bowel), those with complex gastroschisis (bowel perforation, necrosis, or atresia) took longer to reach full enteral feeding (median difference 21 days, 95% confidence interval 9 to 39 days); required a longer duration of parenteral nutrition (median difference 25 days, 9 to 46 days) and a longer stay in hospital (median difference 57 days, 29 to 95 days); were more likely to develop intestinal failure (81% (25 infants) v 41% (102); relative risk 1.96, 1.56 to 2.46) and liver disease associated with intestinal failure (23% (7) v 4% (11); 5.13, 2.15 to 12.3); and were more likely to require unplanned reoperation (42% (13) v 10% (24); 4.39, 2.50 to 7.70). Compared with infants managed with primary fascial closure, those managed with preformed silos took longer to reach full enteral feeding (median difference 5 days, 1 to 9) and had an increased risk of intestinal failure (52% (50) v 32% (38); 1.61, 1.17 to 2.24). Event rates for the other outcomes were low, and there were no other significant differences between these management groups. Twelve infants died (4%). This nationally representative study provides a benchmark against which individual centres can measure outcome and performance. Stratifying neonates with gastroschisis into simple and complex groups reliably predicts outcome at one year. There is sufficient clinical equipoise concerning the

  11. Neurodevelopmental outcome at 2 years of age after general anaesthesia and awake-regional anaesthesia in infancy (GAS): an international multicentre, randomised controlled trial.

    PubMed

    Davidson, Andrew J; Disma, Nicola; de Graaff, Jurgen C; Withington, Davinia E; Dorris, Liam; Bell, Graham; Stargatt, Robyn; Bellinger, David C; Schuster, Tibor; Arnup, Sarah J; Hardy, Pollyanna; Hunt, Rodney W; Takagi, Michael J; Giribaldi, Gaia; Hartmann, Penelope L; Salvo, Ida; Morton, Neil S; von Ungern Sternberg, Britta S; Locatelli, Bruno Guido; Wilton, Niall; Lynn, Anne; Thomas, Joss J; Polaner, David; Bagshaw, Oliver; Szmuk, Peter; Absalom, Anthony R; Frawley, Geoff; Berde, Charles; Ormond, Gillian D; Marmor, Jacki; McCann, Mary Ellen

    2016-01-16

    Preclinical data suggest that general anaesthetics affect brain development. There is mixed evidence from cohort studies that young children exposed to anaesthesia can have an increased risk of poor neurodevelopmental outcome. We aimed to establish whether general anaesthesia in infancy has any effect on neurodevelopmental outcome. Here we report the secondary outcome of neurodevelopmental outcome at 2 years of age in the General Anaesthesia compared to Spinal anaesthesia (GAS) trial. In this international assessor-masked randomised controlled equivalence trial, we recruited infants younger than 60 weeks postmenstrual age, born at greater than 26 weeks' gestation, and who had inguinal herniorrhaphy, from 28 hospitals in Australia, Italy, the USA, the UK, Canada, the Netherlands, and New Zealand. Infants were randomly assigned (1:1) to receive either awake-regional anaesthesia or sevoflurane-based general anaesthesia. Web-based randomisation was done in blocks of two or four and stratified by site and gestational age at birth. Infants were excluded if they had existing risk factors for neurological injury. The primary outcome of the trial will be the Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) Full Scale Intelligence Quotient score at age 5 years. The secondary outcome, reported here, is the composite cognitive score of the Bayley Scales of Infant and Toddler Development III, assessed at 2 years. The analysis was as per protocol adjusted for gestational age at birth. A difference in means of five points (1/3 SD) was predefined as the clinical equivalence margin. This trial is registered with ANZCTR, number ACTRN12606000441516 and ClinicalTrials.gov, number NCT00756600. Between Feb 9, 2007, and Jan 31, 2013, 363 infants were randomly assigned to receive awake-regional anaesthesia and 359 to general anaesthesia. Outcome data were available for 238 children in the awake-regional group and 294 in the general anaesthesia group. In the

  12. Synovial Hemangioma of the Knee Management and Excellent Outcome 2 Years after Arthroscopic Synovectomy in a 25-year-old Male with a 20-year History.

    PubMed

    Bawa, Akshdeep Singh; Garg, Rajnish; Bhatnagar, Kaneeka; Singal, Shekhar

    2017-01-01

    Synovial hemangioma is a rare condition with <200 published case reports in world literature and is frequently misdiagnosed, leading to diagnostic delay of many years. This delay is even more significant if the patient comes from a rural background with a dearth of medical facilities in the area. This case had a lag of nearly 20 years from the time of onset of symptoms and the required management which is the maximum reported for any synovial hemangioma since most of them have been found and treated in adolescents. We present a case of an atypical synovial hemangioma in a 25-year-old Indian male from a poor socioeconomic background with a delay of 20 years who had both recurrent knee effusions and long-standing knee pain but kept ignoring his symptoms. It was managed by arthroscopic synovectomy. The patient reported to us after 2 years after the surgery with a painless knee and full range of movement. Synovial hemangioma mostly affects the knee joint, showing recurrent bloody effusions without a history of trauma. If there are no intermittent effusions, the diagnosis will be even more difficult. In cases of non-specific symptoms and long-standing knee pain of many years, the diagnosis of a synovial hemangioma should also be considered. In this particular case, magnetic resonance imaging was used to evaluate the patient after the plain radiographs and showed characteristic lace-like or linear patterns. Diagnostic arthroscopy and surgical excision were done in the same sitting, and biopsy was sent to the histopathology laboratory which confirmed our diagnosis. Although this patient had the disease since 20 years and presented late, he had little degeneration of cartilage at the time of arthroscopy. The functional outcome at 2-year follow-up was excellent, and he had no disability, effusion and was pain free.

  13. Secondary and 2-Year Outcomes of a Sexual Assault Resistance Program for University Women

    PubMed Central

    Eliasziw, Misha; Hobden, Karen L.; Newby-Clark, Ian R.; Barata, Paula C.; Radtke, H. Lorraine; Thurston, Wilfreda E.

    2017-01-01

    We report the secondary outcomes and longevity of efficacy from a randomized controlled trial that evaluated a novel sexual assault resistance program designed for first-year women university students. Participants (N = 893) were randomly assigned to receive the Enhanced Assess, Acknowledge, Act (EAAA) program or a selection of brochures (control). Perception of personal risk, self-defense self-efficacy, and rape myth acceptance was assessed at baseline; 1-week postintervention; and 6-, 12-, 18-, and 24-month postrandomization. Risk detection was assessed at 1 week, 6 months, and 12 months. Sexual assault experience and knowledge of effective resistance strategies were assessed at all follow-ups. The EAAA program produced significant increases in women’s perception of personal risk, self-defense self-efficacy, and knowledge of effective (forceful verbal and physical) resistance strategies; the program also produced decreases in general rape myth acceptance and woman blaming over the entire 24-month follow-up period. Risk detection was significantly improved for the intervention group at post-test. The program significantly reduced the risk of completed and attempted rape, attempted coercion, and nonconsensual sexual contact over the entire follow-up period, yielding reductions between 30% and 64% at 2 years. The EAAA program produces long-lasting changes in secondary outcomes and in the incidence of sexual assault experienced by women students. Universities can reduce the harm and the negative health consequences that young women experience as a result of campus sexual assault by implementing this program. Online slides for instructors who want to use this article for teaching are available on PWQ’s website at http://journals.sagepub.com/page/pwq/suppl/index. PMID:29503496

  14. Secondary and 2-Year Outcomes of a Sexual Assault Resistance Program for University Women.

    PubMed

    Senn, Charlene Y; Eliasziw, Misha; Hobden, Karen L; Newby-Clark, Ian R; Barata, Paula C; Radtke, H Lorraine; Thurston, Wilfreda E

    2017-06-01

    We report the secondary outcomes and longevity of efficacy from a randomized controlled trial that evaluated a novel sexual assault resistance program designed for first-year women university students. Participants ( N = 893) were randomly assigned to receive the Enhanced Assess, Acknowledge, Act (EAAA) program or a selection of brochures (control). Perception of personal risk, self-defense self-efficacy, and rape myth acceptance was assessed at baseline; 1-week postintervention; and 6-, 12-, 18-, and 24-month postrandomization. Risk detection was assessed at 1 week, 6 months, and 12 months. Sexual assault experience and knowledge of effective resistance strategies were assessed at all follow-ups. The EAAA program produced significant increases in women's perception of personal risk, self-defense self-efficacy, and knowledge of effective (forceful verbal and physical) resistance strategies; the program also produced decreases in general rape myth acceptance and woman blaming over the entire 24-month follow-up period. Risk detection was significantly improved for the intervention group at post-test. The program significantly reduced the risk of completed and attempted rape, attempted coercion, and nonconsensual sexual contact over the entire follow-up period, yielding reductions between 30% and 64% at 2 years. The EAAA program produces long-lasting changes in secondary outcomes and in the incidence of sexual assault experienced by women students. Universities can reduce the harm and the negative health consequences that young women experience as a result of campus sexual assault by implementing this program. Online slides for instructors who want to use this article for teaching are available on PWQ's website at http://journals.sagepub.com/page/pwq/suppl/index .

  15. Long-term outcomes among 2-year survivors of autologous hematopoietic cell transplantation for Hodgkin and diffuse large b-cell lymphoma.

    PubMed

    Myers, Regina M; Hill, Brian T; Shaw, Bronwen E; Kim, Soyoung; Millard, Heather R; Battiwalla, Minoo; Majhail, Navneet S; Buchbinder, David; Lazarus, Hillard M; Savani, Bipin N; Flowers, Mary E D; D'Souza, Anita; Ehrhardt, Matthew J; Langston, Amelia; Yared, Jean A; Hayashi, Robert J; Daly, Andrew; Olsson, Richard F; Inamoto, Yoshihiro; Malone, Adriana K; DeFilipp, Zachariah; Margossian, Steven P; Warwick, Anne B; Jaglowski, Samantha; Beitinjaneh, Amer; Fung, Henry; Kasow, Kimberly A; Marks, David I; Reynolds, Jana; Stockerl-Goldstein, Keith; Wirk, Baldeep; Wood, William A; Hamadani, Mehdi; Satwani, Prakash

    2018-02-15

    Autologous hematopoietic cell transplantation (auto-HCT) is a standard therapy for relapsed classic Hodgkin lymphoma (cHL) and diffuse large B-cell lymphoma (DLBCL); however, long-term outcomes are not well described. This study analyzed survival, nonrelapse mortality, late effects, and subsequent malignant neoplasms (SMNs) in 1617 patients who survived progression-free for ≥2 years after auto-HCT for cHL or DLBCL between 1990 and 2008. The median age at auto-HCT was 40 years; the median follow-up was 10.6 years. The 5-year overall survival rate was 90% (95% confidence interval [CI], 87%-92%) for patients with cHL and 89% (95% CI, 87%-91%) for patients with DLBCL. The risk of late mortality in comparison with the general population was 9.6-fold higher for patients with cHL (standardized mortality ratio [SMR], 9.6) and 3.4-fold higher for patients with DLBCL (SMR, 3.4). Relapse accounted for 44% of late deaths. At least 1 late effect was reported for 9% of the patients. A total of 105 SMNs were confirmed: 44 in the cHL group and 61 in the DLBCL group. According to a multivariate analysis, older age, male sex, a Karnofsky score < 90, total body irradiation (TBI) exposure, and a higher number of lines of chemotherapy before auto-HCT were risk factors for overall mortality in cHL. Risk factors in DLBCL were older age and TBI exposure. A subanalysis of 798 adolescent and young adult patients mirrored the outcomes of the overall study population. Despite generally favorable outcomes, 2-year survivors of auto-HCT for cHL or DLBCL have an excess late-mortality risk in comparison with the general population and experience an assortment of late complications. Cancer 2018;124:816-25. © 2017 American Cancer Society. © 2017 American Cancer Society.

  16. The Helsinki Face Transplantation: Surgical aspects and 1-year outcome.

    PubMed

    Lassus, Patrik; Lindford, Andrew; Vuola, Jyrki; Bäck, Leif; Suominen, Sinikka; Mesimäki, Karri; Wilkman, Tommy; Ylä-Kotola, Tuija; Tukiainen, Erkki; Kuokkanen, Hannu; Törnwall, Jyrki

    2018-02-01

    Since 2005, at least 38 facial transplantations have been performed worldwide. We herein describe the surgical technique and 1-year clinical outcome in Finland's first face transplant case. A 34-year-old male who had a severe facial deformity following ballistic trauma in 1999 underwent facial transplantation at the Helsinki University Hospital on 8th February 2016. Three-dimensional (3D) technology was used to manufacture donor and recipient patient-specific osteotomy guides and a donor face mask. The facial transplant consisted of a Le Fort II maxilla, central mandible, lower ⅔ of the midface muscles, facial and neck skin, oral mucosa, anterior tongue and floor of mouth muscles, facial nerve (three bilateral branches), and bilateral hypoglossal and buccal nerves. At 1-year follow-up, there have thus far been no clinical or histological signs of rejection. The patient has a good aesthetic outcome with symmetrical restoration of the mobile central part of the face, with recovery of pain and light touch sensation to almost the entire facial skin and intraoral mucosa. Electromyography at 1 year has confirmed symmetrical muscle activity in the floor of the mouth and facial musculature, and the patient is able to produce spontaneous smile. Successful social and psychological outcome has also been observed. Postoperative complications requiring intervention included early (nasopalatinal fistula, submandibular sialocele, temporomandibular joint pain and transient type 2 diabetes) and late (intraoral wound and fungal infection, renal impairment and hypertension) complications. At 1 year, we report an overall good functional outcome in Finland's first face transplant. Copyright © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  17. The role of youth mental health services in the treatment of young people with serious mental illness: 2-year outcomes and economic implications.

    PubMed

    Brimblecombe, Nicola; Knapp, Martin; Murguia, Silvia; Mbeah-Bankas, Henrietta; Crane, Steve; Harris, Abi; Evans-Lacko, Sara; Ardino, Vittoria; Iemmi, Valentina; King, Derek

    2017-10-01

    This study aims to evaluate the outcomes and economic case for a UK innovative youth-specific mental health service for 16-25 year olds. A pre-, during- and post-treatment comparative design for 20 young people at high risk of developing psychosis who received 2 years' treatment with the service, using outcomes that concurred with the service aims: changes in mental health, employment rates and service use. Forty-five percent of those at risk and with symptoms of serious mental illness commencing treatment were not receiving mental health services at baseline. Compared with service use prior to treatment at the youth-specific service, hospital admissions, Accident and Emergency, and criminal justice system use appear to decrease over the 2 years of treatment and the year after treatment, with potential cost differences of £473 000. Mental health improved or stayed the same, compared with baseline. Employment rates improved, although the sample size for this is very small. Potential cost differences associated with service users moving into employment over the 2 years are £148 000. The estimated cost over 2 years of providing the youth-specific mental health service to these young people was £106 000. Given the extensive long-term negative consequences and high costs of untreated mental illness in the 16-25 age group and the documented problems young people have in receiving appropriate services, this youth-specific, age-appropriate service model appears to be successful, with improved outcomes and cost differences in the short-term, and with encouraging implications for the longer term. © 2015 Wiley Publishing Asia Pty Ltd.

  18. Preparation and characterization of CuInS2 absorber layers by sol-gel method for solar cell applications

    NASA Astrophysics Data System (ADS)

    Amerioun, M. H.; Ghazi, M. E.; Izadifard, M.; Bahramian, B.

    2016-04-01

    CuInSe2 , CuInS2 ( CIS2 and CuInGaS2 alloys and their compounds with band gaps between 1.05 and 1.7eV are absorbance materials based on chalcopyrite, in which, because of their suitable direct band gap, high absorbance coefficient and short carrier diffusion are used as absorbance layers in solar cells. In this work, the effects of decrease in p H and thickness variation on characteristics of the CIS2 absorber layers, grown by spin coating on glass substrates, are investigated. Furthermore by using thiourea as a sulphur source in solvent, the sulfurization of layers was done easier than other sulfurization methods. Due to the difficulty in dissolving thiourea in the considered solvent that leads to a fast deposition during the dissolving process, precise conditions are employed in order to prepare the solution. In fact, this procedure can facilitate the sulfurization process of CuIn layers. The results obtained from this investigation indicate reductions in absorbance and band gap in the visible region of the spectrum as a result of decrease in p H. Finally, conductivity of layers is studied by the current vs. voltage curve that represents reduction of electrical resistance with decrease and increase in p H and thickness, respectively.

  19. Neurodevelopmental outcome at 2 years for preterm children born at 22 to 34 weeks’ gestation in France in 2011: EPIPAGE-2 cohort study

    PubMed Central

    Marchand-Martin, Laetitia; Arnaud, Catherine; Kaminski, Monique; Resche-Rigon, Matthieu; Lebeaux, Cécile; Bodeau-Livinec, Florence; Morgan, Andrei S; Goffinet, François; Marret, Stéphane; Ancel, Pierre-Yves

    2017-01-01

    Objectives To describe neurodevelopmental outcomes at 2 years corrected age for children born alive at 22-26, 27-31, and 32-34 weeks’ gestation in 2011, and to evaluate changes since 1997. Design Population based cohort studies, EPIPAGE and EPIPAGE-2. Setting France. Participants 5567 neonates born alive in 2011 at 22-34 completed weeks’ gestation, with 4199 survivors at 2 years corrected age included in follow-up. Comparison of outcomes reported for 3334 (1997) and 2418 (2011) neonates born alive in the nine regions participating in both studies. Main outcome measures Survival; cerebral palsy (2000 European consensus definition); scores below threshold on the neurodevelopmental Ages and Stages Questionnaire (ASQ; at least one of five domains below threshold) if completed between 22 and 26 months corrected age, in children without cerebral palsy, blindness, or deafness; and survival without severe or moderate neuromotor or sensory disabilities (cerebral palsy with Gross Motor Function Classification System levels 2-5, unilateral or bilateral blindness or deafness). Results are given as percentage of outcome measures with 95% confidence intervals. Results Among 5170 liveborn neonates with parental consent, survival at 2 years corrected age was 51.7% (95% confidence interval 48.6% to 54.7%) at 22-26 weeks’ gestation, 93.1% (92.1% to 94.0%) at 27-31 weeks’ gestation, and 98.6% (97.8% to 99.2%) at 32-34 weeks’ gestation. Only one infant born at 22-23 weeks survived. Data on cerebral palsy were available for 3599 infants (81.0% of the eligible population). The overall rate of cerebral palsy at 24-26, 27-31, and 32-34 weeks’ gestation was 6.9% (4.7% to 9.6%), 4.3% (3.5% to 5.2%), and 1.0% (0.5% to 1.9%), respectively. Responses to the ASQ were analysed for 2506 children (56.4% of the eligible population). The proportion of children with an ASQ result below threshold at 24-26, 27-31, and 32-34 weeks’ gestation were 50.2% (44.5% to 55.8%), 40.7% (38

  20. Bioresorbable Scaffold for Treatment of Coronary Artery Lesions: Intravascular Ultrasound Results From the ABSORB Japan Trial.

    PubMed

    Okada, Kozo; Honda, Yasuhiro; Kitahara, Hideki; Otagiri, Kyuhachi; Tanaka, Shigemitsu; Hollak, M Brooke; Yock, Paul G; Popma, Jeffrey J; Kusano, Hajime; Cheong, Wai-Fung; Sudhir, Krishnankutty; Fitzgerald, Peter J; Kimura, Takeshi

    2018-04-09

    The aim of this study was to characterize post-procedural intravascular ultrasound (IVUS) findings in the ABSORB Japan trial, specifically stratified by the size of target coronary arteries. Despite overall noninferiority confirmed in recent randomized trials comparing bioresorbable vascular scaffolds (BVS) (Absorb BVS) and cobalt-chromium everolimus-eluting metallic stents (CoCr-EES), higher event rates of Absorb BVS have been reported with suboptimal deployment, especially in small coronary arteries. In the ABSORB Japan trial, 150 patients (2:1 randomization) were scheduled in the IVUS cohort. Small vessel was defined as mean reference lumen diameter <2.75 mm. Tapered-vessel lesions were defined as tapering index (proximal/distal reference lumen diameter) ≥1.2. Overall, IVUS revealed that the Absorb BVS arm had smaller device expansion than the CoCr-EES arm did, which was particularly prominent in small- and tapered-vessel lesions. Higher tapering index was also associated with higher rates of incomplete strut apposition in Absorb BVS, but not in CoCr-EES. With respect to procedural techniques, small-vessel lesions were treated more frequently with noncompliant balloons at post-dilatation but using significantly lower pressure in the Absorb BVS arm. In contrast, tapered-vessel lesions were post-dilated at equivalent pressure but with significantly smaller balloon catheters in the Absorb BVS arm, compared with the CoCr-EES arm. The significantly smaller device expansion especially in small vessels may account for the poorer outcomes of Absorb BVS in this lesion type. Appropriate optimization strategy, possibly different between polymeric and metallic devices, needs to be established for bioresorbable scaffold technology. (AVJ-301 Clinical Trial: A Clinical Evaluation of AVJ-301 Absorb™ BVS) in Japanese Population [ABSORB JAPAN]; NCT01844284). Copyright © 2018 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  1. Does Treatment of the Tibia Matter in Bipolar Chondral Defects of the Knee? Clinical Outcomes with Greater Than 2 Years Follow-up.

    PubMed

    Hannon, Charles P; Weber, Alexander E; Gitelis, Matthew; Meyer, Maximillian A; Yanke, Adam B; Cole, Brian J

    2018-04-01

    To compare the osteochondral allograft (OCA) outcomes of bipolar defects with isolated femoral defects and to investigate the optimal treatment of bipolar defects by comparing femoral OCA with tibial debridement to femoral OCA and tibial microfracture. A series of patients with 2-year follow-up from March 2004 to September 2015 after femoral OCA for bipolar chondral defects was identified. Group 1 contained patients with tibial defects treated with debridement and group 2 contained patients with microfractured tibial defects. A third group (group 3) with isolated femoral defects treated with OCA was identified and matched by gender, body mass index (BMI), laterality, and OCA size to groups 1 and 2. Patient-specific, defect-specific, intraoperative, and postoperative data including patient-reported outcomes were collected on all patients. The study groups were compared using analyses of variance, paired sample t tests, and χ-square analyses. Thirty-six patients who had femoral OCA for bipolar lesions were identified with 20 patients in group 1 and 16 patients in group 2. Group 3 had 20 patients. There were no differences between the 3 groups in terms of gender (P = .616), BMI (P = .271), number of previous surgeries (P = .451), femoral or tibial defect size (P = .296), and OCA size (P = .981). Preoperative to postoperative patient-reported clinical outcomes (PROs) revealed statistical and clinically meaningful improvement in all 3 groups, but did not differ between groups. Patient-specific and defect-specific factors did not correlate with PROs. The graft survivorship for group 1 was 85% at 4.5 years, 100% for group 2 at 2.5 years, and 95% for group 3 at 3.8 years. Regardless of tibial treatment, patients with bipolar defects treated with femoral OCA have clinically meaningful improvements in PROs and excellent graft survivorship comparable to isolated femoral OCAs at more than 2 years. Level III, case-control study. Copyright © 2017 Arthroscopy

  2. Performance of a new carbon dioxide absorbent, Yabashi lime® as compared to conventional carbon dioxide absorbent during sevoflurane anesthesia in dogs.

    PubMed

    Kondoh, Kei; Atiba, Ayman; Nagase, Kiyoshi; Ogawa, Shizuko; Miwa, Takashi; Katsumata, Teruya; Ueno, Hiroshi; Uzuka, Yuji

    2015-08-01

    In the present study, we compare a new carbon dioxide (CO2) absorbent, Yabashi lime(®) with a conventional CO2 absorbent, Sodasorb(®) as a control CO2 absorbent for Compound A (CA) and Carbon monoxide (CO) productions. Four dogs were anesthetized with sevoflurane. Each dog was anesthetized with four preparations, Yabashi lime(®) with high or low-flow rate of oxygen and control CO2 absorbent with high or low-flow rate. CA and CO concentrations in the anesthetic circuit, canister temperature and carbooxyhemoglobin (COHb) concentration in the blood were measured. Yabashi lime(®) did not produce CA. Control CO2 absorbent generated CA, and its concentration was significantly higher in low-flow rate than a high-flow rate. CO was generated only in low-flow rate groups, but there was no significance between Yabashi lime(®) groups and control CO2 absorbent groups. However, the CO concentration in the circuit could not be detected (≤5ppm), and no change was found in COHb level. Canister temperature was significantly higher in low-flow rate groups than high-flow rate groups. Furthermore, in low-flow rate groups, the lower layer of canister temperature in control CO2 absorbent group was significantly higher than Yabashi lime(®) group. CA and CO productions are thought to be related to the composition of CO2 absorbent, flow rate and canister temperature. Though CO concentration is equal, it might be safer to use Yabashi lime(®) with sevoflurane anesthesia in dogs than conventional CO2 absorbent at the point of CA production.

  3. Degradation and mineralization of organic UV absorber compound 2-phenylbenzimidazole-5-sulfonic acid (PBSA) using UV-254nm/H2O2.

    PubMed

    Abdelraheem, Wael H M; He, Xuexiang; Duan, Xiaodi; Dionysiou, Dionysios D

    2015-01-23

    Various studies have revealed the non-biodegradable and endocrine disrupting properties of sulfonated organic UV absorbers, directing people's attention toward their risks on ecological and human health and hence their removal from water. In this study, UV-254nm/H2O2 advanced oxidation process (AOP) was investigated for degrading a model UV absorber compound 2-phenylbenzimidazole-5-sulfonic acid (PBSA) and a structurally similar compound 1H-benzimidazole-2-sulfonic acid (BSA), with a specific focus on their mineralization. At 4.0mM [H2O2]0, a complete removal of 40.0μM parent PBSA and 25% decrease in TOC were achieved with 190min of UV irradiation; SO4(2-) was formed and reached its maximum level while the release of nitrogen as NH4(+) was much lower (around 50%) at 190min. Sulfate removal was strongly enhanced by increasing [H2O2]0 in the range of 0-4.0mM, with slight inhibition in 4.0-12.0mM. Faster and earlier ammonia formation was observed at higher [H2O2]0. The presence of Br(-) slowed down the degradation and mineralization of both compounds while a negligible effect on the degradation was observed in the presence of Cl(-). Our study provides important technical and fundamental results on the HO based degradation and mineralization of SO3H and N-containing UV absorber compounds. Copyright © 2014 Elsevier B.V. All rights reserved.

  4. Dental enamel irradiated with infrared diode laser and photo-absorbing cream: part 2--EDX study.

    PubMed

    de Sant'Anna, Giselle Rodrigues; dos Santos, Edson Aparecido Pereira; Soares, Luís Eduardo Silva; do Espírito Santo, Ana Maria; Martin, Airton Abrahão; Duarte, Danilo Antônio; Pacheco-Soares, Cristina; Brugnera, Aldo

    2009-10-01

    The effects of laser-induced compositional changes on the enamel were investigated by energy-dispersive X-ray fluorescence spectrometry (micro-EDX). After cariogenic challenge, we administered treatment of low-level infrared diode laser and a photo-absorbing cream (used to intensify the superficial light absorption). Dental caries is considered the most prevalent oral disease. A simple and noninvasive caries preventive regimen is treating tooth enamel with a laser, either alone or in combination with fluoride, which reduces enamel solubility and dissolution rates. High power lasers are still not widely used in private practice. Low-power near-infrared lasers may be an alternative approach. Energy-dispersive micro-EDX is a versatile and nondestructive spectroscopic technique that allows for a qualitative and quantitative elemental analysis of inorganic enamel components, such as calcium and phosphorus. Twenty-four extracted or exfoliated caries-free deciduous molars were divided into six groups: 1) control group (CTR-no treatment); 2) infrared laser treatment (L) (lambda = 810 nm, 100 mW/cm(2), 90 sec, 4.47 J/cm(2), 9 J); 3) infrared laser irradiation and photo-absorbing agent (CL); 4) photo-absorbing agent alone (C); 5) infrared laser irradiation and fluoridated photo-absorbing agent (FCL); and 6) fluoridated photo-absorbing agent alone (FC). Samples were analyzed using micro-EDX after two sets of treatments and pH cycling cariogenic challenges. The CL group showed statistically significant increases in calcium and phosphorus (wt%) compared with the CTR group. The Ca/P ratio was similar in the FCL and CTR groups. There was a significant laser-induced reduction compared with the CTR group, and there was a possible modification of the organic balance content in enamel treated with laser and cream. micro-EDX may be able to detect compositional changes in mineral phases of lased enamel under cariogenic challenge. Our results suggest that with a combined laser and photo-absorbing

  5. Breast reconstruction with absorbable mesh sling: dynamic infrared thermography of skin envelope

    PubMed Central

    Hashimoto, Yoko; Yuasa, Takeshi; Suzuki, Yoshinori; Saisho, Hiroshi

    2017-01-01

    Background To immediate reconstruct ptosis breasts, we used polyglactin (Vicryl; Ethicon Inc., Somerville, NJ, USA) mesh as an inferolateral sling. However, Vicryl mesh is absorbable and losing function as a supporting structure. We doubt about the stability of the blood supply to the inferior part of the flap when it is in direct contact with inner implant. In this study, we examine the complications and the safety of the skin flap of this absorbable mesh sling (AMS) procedure. Methods The outcomes of 80 cases were examined, and the 1-year safety record of 40 cases was assessed. Complications were divided into minor complications, major complications requiring surgical intervention, and major complications requiring the reconstructive surgery to be halted. In addition, we examined the blood perfusion of the skin flap by dynamic infrared thermography (DIRT). Results Among 80 patients with AMS procedure, 73 breasts were reconstructed immediately and in one-stage. Complication outcomes are presented; there were 4 cases of minor flap necrosis (5%) and 4 of major complications resulting in surgical correction (5%). One patient required additional surgery, and the implant was moved into the musculocutaneous flap (1.3%). In 40 patients 1 year after surgery, DIRT showed significant decreased of blood perfusion in the ipsilateral inferior sites in comparison with the superior sites. Conclusions Blood perfusion was comparably insufficient in the inferior area of the reconstructed breast mound with AMS, where the pectoralis muscle could not be used to line the inside of the envelope. However, there were no severe flap complications due to ischemia. PMID:28210555

  6. Clinical presentation and outcome of riboflavin transporter deficiency: mini review after five years of experience.

    PubMed

    Jaeger, Bregje; Bosch, Annet M

    2016-07-01

    Riboflavin (vitamin B2) is absorbed in the small intestine by the human riboflavin transporters RFVT1 and RFVT3. A third riboflavin transporter (RFVT2) is expressed in the brain. In 2010 it was demonstrated that mutations in the riboflavin transporter genes SLC52A2 (coding for RFVT2) and SLC52A3 (coding for RFVT3) cause a neurodegenerative disorder formerly known as Brown-Vialetto-Van Laere (BVVL) syndrome, now renamed to riboflavin transporter deficiency. Five years after the diagnosis of the first patient we performed a review of the literature to study the presentation, treatment and outcome of patients with a molecularly confirmed diagnosis of a riboflavin transporter deficiency. A search was performed in Medline, Pubmed using the search terms 'Brown-Vialetto-Van Laere syndrome' and 'riboflavin transporter' and articles were screened for case reports of patients with a molecular diagnosis of a riboflavin transporter deficiency. Reports on a total of 70 patients with a molecular diagnosis of a RFVT2 or RTVT3 deficiency were retrieved. The riboflavin transporter deficiencies present with weakness, cranial nerve deficits including hearing loss, sensory symptoms including sensory ataxia, feeding difficulties and respiratory difficulties which are caused by a sensorimotor axonal neuropathy and cranial neuropathy. Biochemical abnormalities may be absent and the diagnosis can only be made or rejected by molecular analysis of all genes. Treatment with oral supplementation of riboflavin is lifesaving. Therefore, if a riboflavin transporter deficiency is suspected, treatment must be started immediately without first awaiting the results of molecular diagnostics.

  7. The Test of Infant Motor Performance at 3 months predicts language, cognitive, and motor outcomes in infants born preterm at 2 years of age.

    PubMed

    Peyton, Colleen; Schreiber, Michael D; Msall, Michael E

    2018-03-13

    To determine the relationship between the Test of Infant Motor Performance (TIMP) at 3 months and cognitive, language, and motor outcomes on the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III) at 2 years of age in high-risk infants born preterm. One hundred and six infants (47 females, 59 males) born at earlier than 31 weeks gestational age were prospectively tested with the TIMP at 10 to 15 weeks after term age and were assessed again with the Bayley-III at 2 years corrected age. Sensitivity and specificity were calculated for various cut points of the TIMP z-score and Bayley-III composite scores of no more than 85. The TIMP z-scores at 10 to 15 weeks of age were significantly associated with all three subscales on the Bayley-III at 2 years of age (p<0.001). Using a TIMP z-score cutoff of -0.5, specificity was relatively high for cognitive (87%), language (88%), and motor (89%) outcomes, but sensitivity was low (cognitive 41%, language 49%, motor 57%). This study demonstrates that the TIMP is related to cognitive, language, and motor outcomes on the Bayley-III at 2 years of age in high-risk infants born preterm. The Test of Infant Motor Performance (TIMP) predicts Bayley Scales of Infant and Toddler Development, Third Edition outcomes at 2 years of age. The TIMP is relatively good at discriminating between children who will and will not have typical development. © 2018 Mac Keith Press.

  8. Neurodevelopmental outcome at 2 years in twin-twin transfusion syndrome survivors randomized for the Solomon trial.

    PubMed

    van Klink, Jeanine M M; Slaghekke, Femke; Balestriero, Marina A; Scelsa, Barbara; Introvini, Paola; Rustico, Mariangela; Faiola, Stefano; Rijken, Monique; Koopman, Hendrik M; Middeldorp, Johanna M; Oepkes, Dick; Lopriore, Enrico

    2016-01-01

    The preferred treatment for twin-twin transfusion syndrome is fetoscopic laser coagulation of inter-twin vascular anastomoses on the monochorionic placenta. Severe postoperative complications can occur when inter-twin vascular anastomoses remain patent including twin-anemia polycythemia sequence or recurrent twin-twin transfusion syndrome. To minimize the occurrence of residual anastomoses, a modified laser surgery technique, the Solomon technique, was developed in which the entire vascular equator is coagulated. In the Solomon randomized controlled trial (NTR1245), the Solomon technique was associated with a significant reduction in twin-anemia polycythemia sequence and recurrence of twin-twin transfusion syndrome when compared with the standard laser surgery technique. Although a significant improvement in perinatal outcome was shown after the Solomon technique, the clinical importance should also be ascertained with long-term follow-up evaluation of the surviving children. The purpose of this study was to compare the long-term neurodevelopmental outcome in surviving children with twin-twin transfusion syndrome who were included in the Solomon randomized trial and treated with either the Solomon technique or standard laser surgery technique. Routine standardized follow-up evaluation in survivors, at least 2 years after the estimated date of delivery, was performed at 2 of the 5 centers that participated in the Solomon trial: Buzzi Hospital Milan (Italy) and Leiden University Medical Center (The Netherlands). The primary outcome of this follow-up study was survival without long-term neurodevelopmental impairment at age 2 years. Neurodevelopmental impairment was defined as cerebral palsy, cognitive and/or motor development score of <85, bilateral blindness, or deafness. Cognitive and motor development was evaluated with the use of Bayley-III. All analyses per fetus, neonate, or child were conducted with the generalized estimated equation module to account for the

  9. Clinical outcomes of the Realize Adjustable Gastric Band-C at 2 years in a United States population.

    PubMed

    Cunneen, Scott A; Brathwaite, Collin E M; Joyce, Christopher; Gersin, Keith; Kim, Keith; Schram, Jon L; Wilson, Erik B; Schwiers, Michael; Gutierrez, Mario

    2013-01-01

    In 2008, the Realize Band (RB) adopted a precurved design (RB-C). We present 2-year outcomes data from the first multiinstitutional study of RB-C. The objective of this study was to analyze weight loss and safety data from bariatric practices in the United States, including academic, nonacademic, public, and private. The study included adult RB-C patients with a preoperative body mass index (BMI)≥40 kg/m(2) or >35 kg/m(2) with co-morbidity. Exclusions included RB-C's label contraindications for use. Outcomes parameters were percent excess weight loss (%EWL), BMI change, number and volume of band adjustments, and adverse events. A total of 231 patients met inclusion/exclusion criteria. Of these, 161 had 24-month data available. Mean %EWL was 44.4%±26.9% (P<.0001). BMI decreased from 44.1±5.7 kg/m(2) to 35.3±6.9 kg/m(2) (P<.0001). Percent EWL varied by preoperative BMI (P = .0002), bariatric practice (P<.0001), aftercare frequency (P = .0004), and band fill frequency (P = .0271), but %EWL was not influenced by gender, race, or age (P>.20 each). Adverse events were dysphagia (21.2%), gastroesophageal reflux (21.6%), and vomiting (30.7%). Incidence of pouch dilation, esophageal dilation, and slippage was ≤1%. Revisions (2.2%) were for unbuckled band, tube kinking, slippage, and suspected band leak (1 each). No erosions, explants, or mortality were reported. RB-C appears to be as well tolerated and effective as the first generation RB for weight loss. The near 45% EWL at 2 years is consistent with other high-quality publications on the RB. Preoperative BMI and frequency of postoperative care, including frequency of band fills, influence %EWL. Significant weight loss is achievable with RB-C despite variable postoperative management practices. The low morbidity and the absence of mortality at 24 months reflect positively on the RB-C characteristics. Copyright © 2013 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  10. Radiological and functional outcomes 2.7 years following conservatively treated completely displaced midshaft clavicle fractures.

    PubMed

    Fuglesang, Hendrik F S; Flugsrud, Gunnar B; Randsborg, Per-Henrik; Stavem, Knut; Utvåg, Stein E

    2016-01-01

    It is unclear whether all completely displaced midshaft clavicle fractures require primary surgical intervention. The aim of this study was to elucidate the radiological and clinical outcomes after conservative treatment, and to identify subgroups at risk of an inferior outcome. Retrospective case series. Level II trauma center. Between 2005 and 2008, 122 patients were conservatively treated for a completely displaced midshaft clavicle fracture of whom 92 were eligible for inclusion in this study. Of these, 59 completed the study after a median of 2.7 years after the fracture (min-max, 1.1-4.9). The patients received the standard treatment administered at our institution at the time: nonsurgically with a sling without physiotherapy. Patients with painful nonunions were subsequently offered surgery. At follow-up, the patients' Disabilities of Arm, Shoulder, and Hand (DASH) and the Constant scores were evaluated. Radiographs were taken at follow-up and compared to those taken acutely. Nonunion was found in 9 of the 59 (15.3%) patients. Twenty-four (24%) patients reported a fair-to-poor DASH score (i.e. >20). Patients with fractures that were vertically displaced by more than 100% (one bone width) were significantly less satisfied than those with fractures vertically displaced at 100% (p = 0.04). Initial shortening of more than 15 mm was not associated with a worse outcome or nonunion. The odds ratio of developing a nonunion increased with age (p = 0.04). By treating completely displaced midshaft clavicle fractures conservatively with a sling and offering plate fixation for eventual painful nonunions, we found a 24% risk of a fair or poor clinical result with a DASH score over 20. A vertical displacement of more than 100 % between the main fragments on the initial radiograph was associated with an inferior clinical outcome in this study. IV.

  11. 17-year outcome of preterm infants with diverse neonatal morbidities: part 2, impact on activities and participation.

    PubMed

    Sullivan, Mary C; Miller, Robin J; Msall, Michael E

    2012-10-01

    To examine functioning and participation in a diverse U.S. sample of 180 infants at age 17 years. The World Health Organization International Classification of Functioning, Disability and Health model framed functioning and participation domains and contextual factors. Assessment included cognition, executive functioning, academic achievement, personal functioning, community participation, and social involvement. Socioeconomic status, not prematurity, impacted cognitive and academic outcomes. Across neonatal morbidities, male gender and social disadvantage are key determinants of cognitive, academic, and social functioning. Interventions addressing academic and social-behavioral competencies in early school years may potentially optimize long-term preterm outcomes. © 2012, Wiley Periodicals, Inc.

  12. Delta Alert: Expanding Gerotrauma Criteria to Improve Patient Outcomes: A 2-Year Study.

    PubMed

    Wiles, Lynn L; Day, Mark D

    Because of their decreased physical reserve and increased risk of complications, the geriatric trauma patient (GTP) population warrants heightened awareness by clinical staff. The purpose of this study is to determine whether the institution of a third-tier trauma protocol results in a change in GTP outcomes, complications, and mortality rates. Researchers conducted a retrospective review of 2 years of data from the trauma registry, hospital quality improvement audits, and patient charts to examine what, if any, patient outcomes were impacted by the institution of the expanded GTP protocol. Sample homogeneity was determined. Emergency department (ED) length of stay and time to the operating room decreased in the protocol cohort. The rate of complications decreased from 16.4% preprotocol to 1.6% postprotocol. Discharge to home rates in the GTP population improved from 31% preprotocol to nearly 77% postimplementation of the protocol. The expanded GTP protocol front loads evaluation and resuscitation to be consistent with ED trauma protocols already in place. By fast-tracking radiology and laboratory testing, patients injuries are identified and the appropriate consultations are initiated. Appropriate inpatient nursing unit placement is identified or treatment and discharge from the ED are expedited. The expanded GTP protocol provided early and comprehensive evaluation and interventions for GTPs who fall outside of traditional trauma alert criteria. Patients spend less time in the ED and the hospital. Patients had decreased length of stay in the ED, less complications, and return to home rates showed significant improvement after the protocol was implemented.

  13. Time resolved photoluminescence on Cu(In, Ga)Se2 absorbers: Distinguishing degradation and trap states

    NASA Astrophysics Data System (ADS)

    Redinger, Alex; Levcenko, Sergiu; Hages, Charles J.; Greiner, Dieter; Kaufmann, Christian A.; Unold, Thomas

    2017-03-01

    Recent reports have suggested that the long decay times in time resolved photoluminescence (TRPL), often measured in Cu(In, Ga)Se2 absorbers, may be a result of detrapping from sub-bandgap defects. In this work, we show via temperature dependent measurements, that long lifetimes >50 ns can be observed that reflect the true minority carrier lifetime not related to deep trapping. Temperature dependent time resolved photoluminescence and steady state photoluminescence imaging measurements are used to analyze the effect of annealing in air and in a nitrogen atmosphere between 300 K and 350 K. We show that heating the Cu(In, Ga)Se2 absorber in air can irreversibly decrease the TRPL decay time, likely due to a deterioration of the absorber surface. Annealing in an oxygen-free environment yields a temperature dependence of the TRPL decay times in accordance with Schockley Read Hall recombination kinetics and weakly varying capture cross sections according to T0.6.

  14. Employment outcome and predictors of competitive employment at 2-year follow-up of a vocational rehabilitation programme for individuals with schizophrenia in a high-income welfare society.

    PubMed

    Evensen, Stig; Ueland, Torill; Lystad, June Ullevoldsæter; Bull, Helen; Klungsøyr, Ole; Martinsen, Egil W; Falkum, Erik

    2017-04-01

    Employment is an important part of recovery for individuals with schizophrenia. The employment rate for this group is as low as 10% in Norway, and major system related barriers to employment are evident. This study reports the competitive employment outcome at 2-year follow-up of a vocational rehabilitation study augmented with cognitive remediation (CR) or elements from cognitive behaviour therapy (CBT) for individuals with schizophrenia spectrum disorders. It also investigates if global functioning, self-esteem, and depression at baseline predicts employment outcome, and if change in these variables during the intervention period is associated with employment outcome. One hundred and forty-eight participants with schizophrenia spectrum disorders in six Norwegian counties received 10 months vocational rehabilitation augmented with either CBT (n = 84) or CR (n = 64). Both competitive and sheltered workplaces were used. Participants were assessed at baseline, at the end of the intervention period, and at 2-year follow-up. At 2-year follow-up, 21.2% had obtained competitive employment. A further 25.3% had work placements in competitive workplaces. Significant improvements were found in global functioning, self-esteem, and depression during the intervention period, but no significant differences between the two intervention groups. High baseline global functioning and self-esteem, as well as positive change in these variables during the intervention period, were significantly associated with higher competitive employment outcome at 2-year follow-up. The results add to existing evidence that competitive employment is attainable for individuals with schizophrenia. High global functioning and self-esteem were strongly associated with competitive employment outcome.

  15. Surgical impact and speech outcome at 2.5 years after one- or two-stage cleft palate closure.

    PubMed

    Randag, Anna C; Dreise, Marieke M; Ruettermann, Mike

    2014-11-01

    In the ongoing discussion about timing of palate closure, it is said that early closure is favorable for speech development, but can interfere with maxillary growth. On the other hand, beneficial results on both after one-stage palate closure have also been presented. The assumption that one-stage palate closure leads to less surgical impact on the child probably contributed to the choice for this procedure in most cleft centers. However, no previous research has verified this assumption. The aim of the present study is to compare surgical impact and speech outcome at 2.5 years of age between children who underwent either one- or early two-stage palate closure. Patients underwent either one-stage palate closure between 2007 and 2010 at a median age of 10.8 months (group 1, n=24) or early two-stage closure before 2007 at median ages of 10.4 and 18.2 months, respectively (group 2, n=24). Surgical impact was compared between the two groups by means of duration of surgery, length of hospital stay and number of post-operative complications. Speech outcome was compared by means of resonance problems, nasal air emission, articulation and intelligibility, all assessed at a median age of 2.5 years. The one-stage closure group showed significantly shorter duration of surgery and length of hospital stay (p<0.001 and p=0.001, respectively) and significantly better articulation (p=0.029) than the early two-stage closure group. One-stage palate closure is preferable over early two-stage palate closure with regard to surgical impact and speech development. More extensive, prospective studies, in which maxillary growth is taken into account, should be conducted. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  16. Pregnancy Outcome of Multiparous Women Aged over 40 Years

    PubMed Central

    Ates, Seda; Batmaz, Gonca; Sevket, Osman; Molla, Taner; Dane, Cem; Dane, Banu

    2013-01-01

    Objective. The aim of this study was to evaluate the effect of maternal age on prenatal and obstetric outcome in multiparaous women. Materials and Methods. A retrospective case control study was conducted, including women aged 40 years and over (study group, n = 97) who delivered at 20 week's gestation or beyond and women aged 20–29 years (control group, n = 97). Results. The mean age of women in the study group was 41.2 ± 1.7 years versus 25.4 ± 2.3 years in the control group. Advanced maternal age was associated with a significantly higher rate of hypertension, diabetes mellitus, fetal complication, and 5-minute Apgar scores <7 (P < 0.05). Caeserean section rate, incidence of placental abruption, preterm delivery, and neonatal intensive care unit admission were more common in the older group, but the differences were not statistically significant. Conclusions. Advanced maternal age is related to maternal and neonatal complications. PMID:25954770

  17. Fabrication of a saturable absorber WS2 and its mode locking in solid-state laser

    NASA Astrophysics Data System (ADS)

    Zhang, Chun-Yu; Zhang, Ling; Tang, Xiao-Ying; Yang, Ying-Ying

    2018-04-01

    We report on a passively mode-locked Nd : LuVO4 laser using a type saturable absorber of tungsten disulfide (WS2) fabricated by chemical vapor deposition method. At the pump power of 3.3 W, 1.18-W average output power of continuous-wave mode-locked laser with optical conversion efficiency of 36% was achieved. To the best of our knowledge, this is the highest output power of passively mode-locked solid-state laser based on WS2. The repetition rate of passively mode-locked pulse was 80 MHz with the pulse energy of 14.8 nJ. Our experimental results show that WS2 is an excellent type of saturable absorber.

  18. Microcytosis is associated with low cognitive outcomes in healthy 2-year-olds in a high-resource setting.

    PubMed

    McCarthy, Elaine K; Kiely, Mairead E; Hannon, Geraldine; Ahearne, Caroline; Kenny, Louise C; Hourihane, Jonathan O'B; Irvine, Alan D; Murray, Deirdre M

    2017-09-01

    Fe deficiency in early childhood is associated with long-term consequences for cognitive, motor and behavioural development; however explorations in healthy children from low risk, high-resource settings have been limited. We aimed to explore associations between Fe status and neurodevelopmental outcomes in low risk, healthy 2-year-olds. This study was a secondary analysis of a nested case-control subgroup from the prospective, maternal-infant Cork Babies after Screening for Pregnancy Endpoints: Evaluating the Longitudinal Impact using Neurological and Nutritional Endpoints (BASELINE) Birth Cohort Study. At 2 years, serum ferritin, Hb and mean corpuscular volume (MCV) were measured and neurodevelopment was assessed using the Bayley Scales of Infant and Toddler Development (n 87). Five children had Fe deficiency (ferritin <12 µg/l) and no child had Fe deficiency anaemia (Hb<110 g/l+ferritin<12 µg/l). Children with microcytosis (MCV<74 fl, n 13) had significantly lower mean cognitive composite scores (88·5 (sd 13·3) v. 97·0 (sd 7·8), P=0·04, Cohen's d effect size=0·8) than those without microcytosis. The ferritin concentration which best predicted microcytosis was calculated as 18·4 µg/l (AUC=0·87 (95% CI 0·75, 0·98), P<0·0001, sensitivity 92 %, specificity 75 %). Using 18·5 µg/l as a threshold, children with concentrations <18·5 µg/l had significantly lower mean cognitive composite scores (92·3 (sd 10·5) v. 97·8 (sd 8·1), P=0·012, Cohen's d effect size=0·6) compared with those with ferritin ≥18·5 µg/l. All associations were robust after adjustment for potential confounding factors. Despite a low prevalence of Fe deficiency using current diagnostic criteria in this healthy cohort, microcytosis was associated with lower cognitive outcomes at 2 years. This exploratory study emphasises the need for re-evaluation of the diagnostic criteria for Fe deficiency in young children, with further research in adequately powered studies warranted.

  19. X-ray Luminosity and Absorption Column Fluctuations in the H2O Maser Galaxy NGC 4258 from Weeks to Years

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Argon, A.

    2004-07-30

    The authors report monitoring of the 0.3-10 keV spectrum of NGC 4258 with the XMM-Newton observatory at five epochs over 1.5 years. They also report reprocessing of an overlapping four epoch series of archival Chandra observations (0.5-10 keV). By including earlier ASCA and Beppo-SAX observations, they present a new, nine year time-series of models fit to the X-ray spectrum of NGC 4258. They model the Chandra and XMM-Newton data self-consistently with partially absorbed, hard power-law, soft thermal plasma, and soft power-law components. Over the nine years, the photo-electric absorbing column ({approx} 10{sup 23} cm{sup -2}) did not vary detectably, exceptmore » for a {approx} 40% drop between two ASCA epochs separated by 3 years (in 1993 and 1996) and a {approx} 60% rise between two XMM-Newton epochs separated by just 5 months (in 2001 and 2002). In contrast, factor of 2-3 changes are seen in absorbed flux on the timescale of years. These are uncorrelated with changes in absorbing column and indicative of central engine variability. The most rapid change in luminosity (5-10 keV) that the authors detect (with XMM-Newton and Chandra) is on the order of 30% over 19 days. The warped disk that is a known source of H{sub 2}O maser emission in NGC 4258 is believed to cross the line of sight to the central engine. They propose that the variations in absorbing column arise from inhomogeneities in the rotating disk, as they sweep across the line of sight. They estimate that the inhomogeneities are {approx} 10{sup 15} cm in size.« less

  20. Outcomes of hip arthroscopy in patients aged 50 years or older compared with a matched-pair control of patients aged 30 years or younger.

    PubMed

    Domb, Benjamin G; Linder, Dror; Finley, Zachary; Botser, Itamar B; Chen, Austin; Williamson, Joseph; Gupta, Asheesh

    2015-02-01

    Age has been suggested as a negative prognostic factor for hip arthroscopy. The purpose of this study was to compare patient characteristics and outcomes after hip arthroscopy in patients aged 50 years or older with a matched control group of patients aged 30 years or younger at a minimum postoperative follow-up of 2 years. Between September 2008 and March 2010, data were prospectively collected on all patients aged 50 years or older undergoing primary hip arthroscopy. Fifty-two patients met our inclusion and matching criteria, of whom all 52 (100%) were available for follow-up at a minimum of 2 years. This cohort was compared with a matched-pair control group of patients aged 30 years or younger who underwent similar procedures. The mean age of the study group was 54.8 years (range, 50 to 69 years), and that of the control group was 20.3 years (range, 13 to 30 years). The groups were matched at a 1:1 ratio, including 18 male patients (34.6%) and 34 female patients (65.4%) in each group, with a mean follow-up period of 32 months (range, 24 to 54 months). In the younger control group, the score improvement from preoperatively to 2 years' follow-up was 62.9 to 84.2 for the modified Harris Hip Score, 60.5 to 84.2 for the Non-Arthritic Hip Score, 63.1 to 86.5 for the Hip Outcome Score-Activities of Daily Living, and 42.2 to 72.7 for the Hip Outcome Score-Sport-Specific Subscale. In the older study group, the score improvement from preoperatively to 2 years' follow-up was 61.2 to 82.2 for the modified Harris Hip Score, 59.9 to 80.4 for the Non-Arthritic Hip Score, 63.9 to 83 for the Hip Outcome Score-Activities of Daily Living, and 41.2 to 64.6 for the Hip Outcome Score-Sport-Specific Subscale. All improvements in both groups were statistically significant at the 2-year postoperative follow-up (P < .001). There was no significant difference for all patient-reported outcome (PRO) scores at final follow-up between both groups. When we compared the change in PRO scores (

  1. High Throughput Light Absorber Discovery, Part 2: Establishing Structure-Band Gap Energy Relationships.

    PubMed

    Suram, Santosh K; Newhouse, Paul F; Zhou, Lan; Van Campen, Douglas G; Mehta, Apurva; Gregoire, John M

    2016-11-14

    Combinatorial materials science strategies have accelerated materials development in a variety of fields, and we extend these strategies to enable structure-property mapping for light absorber materials, particularly in high order composition spaces. High throughput optical spectroscopy and synchrotron X-ray diffraction are combined to identify the optical properties of Bi-V-Fe oxides, leading to the identification of Bi 4 V 1.5 Fe 0.5 O 10.5 as a light absorber with direct band gap near 2.7 eV. The strategic combination of experimental and data analysis techniques includes automated Tauc analysis to estimate band gap energies from the high throughput spectroscopy data, providing an automated platform for identifying new optical materials.

  2. HS 1603+3820 and its Warm Absorber

    NASA Astrophysics Data System (ADS)

    Nikołajuk, M.; Różańska, A.; Czerny, B.; Dobrzycki, A.

    2009-07-01

    We use photoionization codes CLOUDY and TITAN to obtain physical conditions in the absorbing medium close to the nucleus of a distant quasar (z = 2.54) HS 1603+3820. We found that the total column density of this Warm Absorber is 2 x 1022 cm-2. Due to the softness of the quasars spectrum the modelling allowed us also to determine uniquely the volume hydrogen density of this warm gas (n = 1010 cm-3) which combined with the other quasar parameters leads to a distance determination to the Warm Absorber from the central source which is ~ 1.5 x 1016 cm.

  3. Three-year outcome of shunted idiopathic NPH patients.

    PubMed

    Aygok, G; Marmarou, A; Young, H F

    2005-01-01

    The incidence of idiopathic normal pressure hydrocephalus (iNPH) has increased as a result of improved longevity. This report describes the 3-year outcome of shunted iNPH patients compared to three-month outcome after shunting. Patients (n = 50) (Age 70.4 +/- 8.9) admitted to our service were diagnosed and treated according to a fixed protocol for management of iNPH and after shunting were followed at least three times per year in clinic. The outcome of 50 patients was graded according to the level of improvement in symptoms as Excellent/Good, Partial or None in each category of Gait, Incontinence and Dementia. If we lump favorable (excellent, good, partial recovery) vs poor recovery (none), we found from 3 months to 3 years, a moderate decline in gait performance (91% to 75%), a retention of memory improvement (80%-80%) and an improvement in incontinence occurred over time (70%-82.5%). With proper diagnosis and management of iNPH, shunting of patients is associated with a favorable risk/benefit ratio that is reasonably long lasting.

  4. Near-infrared tunable multiple broadband perfect absorber base on VO2 semi-shell arrays photonic microstructure and gold reflector

    NASA Astrophysics Data System (ADS)

    Liang, Jiran; Li, Peng; Zhou, Liwei; Guo, Jinbang; Zhao, Yirui

    2018-01-01

    We proposed a metamaterial absorber which is aimed to achieve a multiple broadband absorption and tunable absorption peak in the near-infrared region. The absorber is based on VO2 semi-shell coated on the top of silica nano-particle array supported on the gold-reflective layer. Measured results show that the absorber has the multiple broadband with the absorption magnitudes more than 95% in the near infrared region. The absorption peaks can be tuned through the VO2 phase transition from metallic phase to insulator phase in the short wavelength (before λ = 1500 nm), when VO2 is at the metallic state, an absorption band appears in the long wavelength (after λ = 1500 nm). The simulation results closely match those of measured. The absorption intensity becomes stronger and absorption peaks have red shift with the increase of thickness of VO2 semi-shell. Thus, this designed tunable absorption intensity and position absorber based on VO2 can be a good choice for enhancing the performance of multiple band, this would be beneficial to the field of photo detectors, sensor and solar cell.

  5. Similar Outcomes After Osteochondral Allograft Transplantation in Anterior Cruciate Ligament-Intact and -Reconstructed Knees: A Comparative Matched-Group Analysis With Minimum 2-Year Follow-Up.

    PubMed

    Wang, Dean; Eliasberg, Claire D; Wang, Tim; Fader, Ryan R; Coxe, Francesca R; Pais, Mollyann D; Williams, Riley J

    2017-12-01

    To compare failure rates and clinical outcomes of osteochondral allograft transplantation (OCA) in anterior cruciate ligament (ACL)-intact versus ACL-reconstructed knees at midterm follow-up. After a priori power analysis, a prospective registry of patients treated with OCA for focal chondral lesions ≥2 cm 2 in size with minimum 2-year follow-up was used to match ACL-reconstructed knees with ACL-intact knees by age, sex, and primary chondral defect location. Exclusion criteria included meniscus transplantation, realignment osteotomy, or other ligamentous injury. Complications, reoperations, and patient responses to validated outcome measures were reviewed. Failure was defined by any procedure involving allograft removal/revision or conversion to arthroplasty. Kaplan-Meier analysis and multivariate Cox regression were performed to evaluate the association of ACL reconstruction (ACLR) with failure. A total of 50 ACL-intact and 25 ACL-reconstructed (18 prior, 7 concomitant) OCA patients were analyzed. The mean age was 36.2 years (range, 14-62 years). Mean follow-up was 3.9 years (range, 2-14 years). Patient demographics and chondral lesion characteristics were similar between groups. ACL-reconstructed patients averaged 2.2 ± 1.9 prior surgeries on the ipsilateral knee compared with 1.4 ± 1.4 surgeries for ACL-intact patients (P = .014). Grafts used for the last ACLR included bone-patellar tendon-bone autograft, hamstring autograft, Achilles tendon allograft, and tibialis allograft (data available for only 11 of 25 patients). At final follow-up, 22% of ACL-intact and 32% of ACL-reconstructed patients had undergone reoperation. OCA survivorship was 90% and 96% at 2 years and 79% and 85% at 5 years in ACL-intact and ACL-reconstructed patients, respectively (P = .774). ACLR was not independently associated with failure. Both groups demonstrated clinically significant improvements in the Short Form-36 pain and physical functioning, International Knee

  6. Effect of case management on glycemic control and behavioral outcomes for chinese people with type 2 diabetes: A 2-year study.

    PubMed

    Yuan, Xiaodan; Wang, Fengmei; Fish, Anne Folta; Xue, Cunyi; Chen, Tao; Liu, Chao; Lou, Qingqing

    2016-08-01

    To examine the effect of case management on glycemic control and behavioral outcomes in adults with Type 2 diabetes in China. Participants were randomly assigned to a 1-year case management (CM) group (n=60) or control group (n=60). Monthly case management visits included identifying individuals' diabetes-related problems, setting goals, planning self-care, and evaluating progress. During a 1-year follow-up, all participants attended visits every 3 months without intervention. In the CM vs. the control group, HbA1c was reduced at 6 months compared to baseline (P=0.034), with trends at 12 and 24 months, and empowerment ability improved (P<0.05). Also in the CM vs. controls, total self-care behaviors, the frequency of exercise, blood glucose testing, and foot care were higher (P<0.001) at 12 months, and the percentage of individuals with HbA1c ≤7.0% was higher (P=0.035) at 24 months. The case management intervention in China was effective at 6 months and, based on trends in HbA1c at 12 and 24 months and results for behavioral outcomes, the intervention shows promise and warrants more research. A case management approach can enhance behavior change and glycemic control in Chinese with diabetes. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  7. 360-degree suture trabeculotomy ab interno to treat open-angle glaucoma: 2-year outcomes

    PubMed Central

    Sato, Tomoki; Kawaji, Takahiro; Hirata, Akira; Mizoguchi, Takanori

    2018-01-01

    Purpose The purpose of this study was to evaluate the efficacy of 360-degree suture trabeculotomy (360S-LOT) ab interno for treating open-angle glaucoma (OAG). Risk factors of surgical failure were examined. Patients and methods 360S-LOT ab interno alone was performed for patients with uncontrolled OAG, and combined 360S-LOT ab interno/phacoemulsification was performed for patients with controlled OAG with a visually significant cataract between March 2014 and September 2015 at a single center. The patients were prospectively followed for 2 years. The main outcome measures included 2-year intraocular pressure (IOP), number of anti-glaucoma medications used, postoperative complications, and predictive factors of surgical failure. Kaplan–Meier analysis was performed, with surgical success (with or without medication use) defined as postoperative IOP ≤15 mmHg and IOP reduction ≥20% (criterion A) or IOP ≤12 mmHg and IOP reduction ≥30% (criterion B). Predictive factors were evaluated using Cox proportional hazard ratios. Results A total of 64 eyes of 64 patients were included, and 50 (78%) eyes of 64 eyes underwent a phacoemulsification combination procedure. Surgery significantly reduced IOP from 18.4 ± 2.9 mmHg before surgery to 13.4 ± 3.0 mmHg after surgery (P < 0.001). Patients used an average of 1.8 ± 1.5 medications before surgery and 1.3 ± 1.5 medications after surgery (P = 0.101). No serious postoperative complications were observed. The probability of surgical success was 49.2% and 16.0% using criteria A and B, respectively. No risk factors of surgical failure were identified. Conclusion The 360S-LOT ab interno procedure is a favorable option for treating eyes with mild or moderate OAG. PMID:29844656

  8. Clinical Outcomes after Conservative Management of Cervical Intraepithelial Neoplasia Grade 2 (CIN2) in Women Ages 21-39 Years.

    PubMed

    Silver, Michelle I; Gage, Julia C; Schiffman, Mark; Fetterman, Barbara; Poitras, Nancy E; Lorey, Thomas; Cheung, Li C; Katki, Hormuzd A; Locke, Alexander; Kinney, Walter K; Castle, Philip E

    2018-03-01

    Cervical intraepithelial neoplasia grade 2 (CIN2) frequently regresses, is typically slow-growing, and rarely progresses to cancer. Some women forgo immediate treatment, opting for conservative management (heightened surveillance with cytology and colposcopy), to minimize overtreatment and increased risk of obstetric complications; however, there are limited data examining clinical outcomes in these women. We performed a retrospective cohort analysis of younger women diagnosed with initially untreated CIN1/2, CIN2 and CIN2/3 lesions at Kaiser Permanente Northern California between 2003 and 2015. Clinical outcomes were categorized into five mutually exclusive hierarchical groups: cancer, treated, returned to routine screening, persistent high-grade lesion, or persistent low-grade lesion. Median follow-up for the 2,417 women was 48 months. Six women were diagnosed with cancer (0.2%), all with history of high-grade cytology, and none after a negative cotest. Thirty percent of women were treated, and only 20% returned to routine screening; 50% remained in continued intensive follow-up, of which 86% had either low-grade cytology/histology or high-risk human papillomavirus (HPV) positivity, but not necessarily persistence of a single HPV type. No cancers were detected after a single negative cotest in follow-up. Almost half of initially untreated women did not undergo treatment, but remained by protocol in colposcopy clinic for 2 or more years in the absence of persisting CIN2 + Their incomplete return to total negativity was possibly due to sequential new and unrelated low-grade abnormalities. The prolonged colposcopic surveillance currently required to return to routine screening in the absence of persisting CIN2 + might not be necessary after a negative cotest. Significance: Many younger women under conservative management following an initial CIN2 result remain in a clinical protocol of prolonged intensified surveillance without a subsequent diagnosis of CIN2 or more

  9. Aging behavior of near atmospheric N2 ambient sputtered/patterned Au IR absorber thin films

    NASA Astrophysics Data System (ADS)

    Gaur, Surender P.; Kothari, Prateek; Rangra, Kamaljit; Kumar, Dinesh

    2018-03-01

    Near atmospheric N2 ambient sputtered Au thin films exhibit significant spectral absorptivity over medium to long wave infrared radiations. Thin films were found adequately robust for micropatterning using conventional photolithography and metal lift off processes. Since long term spectral absorptivity is major practical concern for Au blacks, this paper reports on aging behavior of near atmospheric Ar and Ar + N2 (1:1) ambient sputtered infrared absorber Au thin films. Comparative analysis on electrical, morphological and spectral absorption behavior of twenty-five weeks room temperature/vacuum aged Au infrared absorber thin films is performed. The Ar and Ar + N2 ambient sputtered Au thing films have shown anticipated consistency in their physical, electrical and spectral properties regardless the long term aging in this work.

  10. Narrowing the Gap in Outcomes: Early Years (0-5 Years)

    ERIC Educational Resources Information Center

    Springate, Ian; Atkinson, Mary; Straw, Suzanne; Lamont, Emily; Grayson, Hilary

    2008-01-01

    This report was commissioned by the Local Government Association (LGA) to inform the Department for Children, Schools and Families (DCSF) and LGA work on "Narrowing the Gap." It focuses on early years' provision and presents findings from a review of the best evidence on narrowing the gap in outcomes across the five Every Child Matters…

  11. 2-Year Outcomes of High Bleeding Risk Patients After Polymer-Free Drug-Coated Stents.

    PubMed

    Garot, Philippe; Morice, Marie-Claude; Tresukosol, Damras; Pocock, Stuart J; Meredith, Ian T; Abizaid, Alexandre; Carrié, Didier; Naber, Christoph; Iñiguez, Andres; Talwar, Suneel; Menown, Ian B A; Christiansen, Evald H; Gregson, John; Copt, Samuel; Hovasse, Thomas; Lurz, Philipp; Maillard, Luc; Krackhardt, Florian; Ong, Paul; Byrne, Jonathan; Redwood, Simon; Windhövel, Ute; Greene, Samantha; Stoll, Hans-Peter; Urban, Philip

    2017-01-17

    A 1-year follow-up, polymer-free metallic stent coated with biolimus-A9 followed by 1-month dual antiplatelet therapy is safer and more effective than a bare-metal stent (BMS) for patients with high risk of bleeding. This study analyzed 2-year outcomes to determine whether these benefits are maintained. In a prospective, multicenter, double-blind trial, we randomized 2,466 high bleeding risk patients to receive a drug-coated stent (DCS) or a BMS followed by 1-month dual antiplatelet therapy. The primary safety endpoint was a composite of cardiac death, myocardial infarction, or stent thrombosis. The primary efficacy endpoint was clinically driven target lesion revascularization. At 2 years, the primary safety endpoint had occurred in 147 DCS and 180 BMS patients (15.3%) (hazard ratio: 0.80; 95% confidence interval: 0.64 to 0.99; p = 0.039). Clinically driven target lesion revascularization occurred for 77 DCS and 136 BMS patients (12.0%) (hazard ratio: 0.54; 95% confidence interval: 0.41 to 0.72; p < 0.0001). Major bleeding occurred in 8.9% of DCS and 9.2% of BMS patients (p = 0.95), and a coronary thrombotic event (myocardial infarction and/or stent thrombosis) occurred in 8.2% of DCS and 10.6% of BMS patients (p = 0.045). One-year mortality was 27.1% for a major bleed and 26.3% for a thrombotic event. At 2 years, multivariate correlates of major bleeding were age >75 years, anemia, raised plasma creatinine, and planned long-term anticoagulation. Correlates of the primary safety endpoint were age, anemia, congestive heart failure, multivessel disease, number of stents implanted, and use of a BMS rather than a DCS. Safety and efficacy benefits of DCS over BMS were maintained for 2 years in high bleeding risk patients. Rates of major bleeding and coronary thrombotic events were no different and were associated with a substantial and comparable mortality risk. (A Prospective Randomized Comparison of the BioFreedom Biolimus A9 Drug Coated Stent Versus the

  12. One-year results of maxillary overdentures supported by 2 titanium-zirconium implants - implant survival rates and radiographic outcomes.

    PubMed

    Zembic, Anja; Tahmaseb, Ali; Jung, Ronald E; Wismeijer, Daniel

    2017-07-01

    To assess implant survival rates and peri-implant bone loss of 2 titanium-zirconium implants supporting maxillary overdentures at 1 year of loading. Twenty maxillary edentulous patients (5 women and 15 men) being dissatisfied with their complete dentures were included. In total, 40 diameter-reduced titanium-zirconium implants were placed in the anterior maxilla. Local guided bone regeneration (GBR) was allowed if the treatment did not compromise implant stability. Following 3 to 5 months of healing, implant-supported overdentures were inserted on two ball anchors. Implants and overdentures were assessed at 1, 2, 4, and 8 weeks after implant insertion and 2, 4, and 12 months after insertion of overdentures (baseline). Standardized radiographs were taken at implant loading and 1 year. Implant survival rates and bone loss were the primary outcomes. Nineteen patients (1 dropout) with 38 implants were evaluated at a mean follow-up of 1.1 years (range 1.0-1.7 years). One implant failed resulting in an implant survival rate of 97.3%. There was a significant peri-implant bone loss of the implants at 1 year of function (mean, 0.7 mm, SD = 1.1 mm; median: 0.48 mm, IQR = 0.56 mm). There was a high 1-year implant survival rate for edentulous patients receiving 2 maxillary implants and ball anchors as overdenture support. However, several implants exhibited an increased amount of bone loss of more than 2 mm. Overdentures supported by 2 maxillary implants should thus be used with caution as minimally invasive treatment for specific patients encountering problems with their upper dentures until more long-term data is available. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  13. Sex Differences in the Management and 5-Year Outcome of Young Patients (<55 Years) with Acute Coronary Syndromes.

    PubMed

    Sabbag, Avi; Matetzky, Shlomi; Porter, Avital; Iakobishvili, Zaza; Moriel, Mady; Zwas, Donna; Fefer, Paul; Asher, Elad; Beigel, Roy; Gottlieb, Shmuel; Goldenberg, Ilan; Segev, Amit

    2017-11-01

    Young women are usually protected against coronary artery disease due to hormonal and risk-factor profile. Previous studies have suggested poorer outcome in women hospitalized with acute coronary syndrome as compared with men. However, when adjusted for age and other risk factors, this difference does not remain significant. We compared the risk profile and outcome between young (≤55 years) women and men admitted with acute coronary syndrome. We analyzed clinical characteristics, management strategies, and outcomes of men and women ≤55 years of age enrolled in the biennial Acute Coronary Syndrome Israeli Surveys between 2000 and 2013. Among 11,536 patients enrolled, 3949 (34%) were ≤55 years old (407 women, 3542 men). Women were slightly older (48.9 ± 5.7 vs 48.3 ± 5.5, P = .007) and suffered more from diabetes (34% vs 24%) and hypertension (47% vs 37%, P <.001 for both). Rates of prior myocardial infarction were high in both sexes (18% vs 21%). Women presented less often with ST-elevation myocardial infarction (50% vs 57%, P = .007) and with typical chest pain (73% vs 80%, P = .004), and had higher rates of Global Registry of Acute Coronary Events (GRACE) score ≥140 (19% vs 12%, P = .007). After adjustment for GRACE score, diabetes, and enrollment year, women had a lower likelihood to undergo coronary angiography during hospitalization (odds ratio 0.6, P = .007). Female sex was independently associated with higher risk of in-hospital mortality (hazard ratio [HR] 4.1; 95% confidence interval [CI], 1.15-14.0), 30-day major adverse cardiac and cerebral events (HR 2.1; 95% CI, 1.31-3.36), and 5-year mortality (HR 1.96; 95% CI, 1.3-2.8). Young women admitted with acute coronary syndrome are a unique high-risk group that presents a diagnostic challenge for clinicians. Women receive less invasive therapy during hospitalization and have worse in-hospital and long-term outcomes. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. The CVD ZrB2 as a selective solar absorber

    NASA Astrophysics Data System (ADS)

    Randich, E.; Allred, D. D.

    Coatings of ZrB2 and TiB2 for photothermal solar absorber applications were prepared using chemical vapor deposition (CVD) techniques. Oxidation tests suggest a maximum temperature limit for air exposure of 600 K for TiB2 and 800 K for Z4B2. Both materials exhibit innate spectral selectivity with emittance at 375 K ranging from 0.06 to 0.09 and solar absorptance for ZrB2 ranging from 0.67 to 0.77 and solar absorptance for TiB2 ranging from 0.46 to 0.58. ZrB2 has better solar selectivity and more desirable oxidation behavior than TiB2. A 0.071 micrometer antireflection coating of Si3N4 deposited on the ZrB2 coating leads to an increase in absorptance from 0.77 to 0.93, while the emittance remains unchanged.

  15. Endoscopic Gluteus Medius Repair With Concomitant Arthroscopy for Labral Tears: A Case Series With Minimum 5-Year Outcomes.

    PubMed

    Perets, Itay; Mansor, Yosif; Yuen, Leslie C; Chen, Austin W; Chaharbakhshi, Edwin O; Domb, Benjamin G

    2017-12-01

    To report the minimum 5-year outcomes of endoscopic gluteus medius repair for partial- and full-thickness tears with concomitant hip arthroscopy. Data for all patients who underwent hip arthroscopy between February 2009 and September 2011 were prospectively collected. We included patients who underwent endoscopic gluteus medius repair with concomitant arthroscopic labral treatment and for whom the following measures were obtained preoperatively and at a minimum of 5 years' follow-up: modified Harris Hip Score, Non-Arthritic Hip Score, Hip Outcome Score-Sports Specific Subscale, and visual analog scale score for pain. For included patients, the International Hip Outcome Tool-12 (iHOT-12) score and satisfaction rating were also available at latest follow-up. Patients with at least 1 of the following criteria were excluded: preoperative Tönnis osteoarthritis grade of 2 or greater, previous hip conditions, severe dysplasia, and Workers' Compensation claims. There were 16 patients eligible for inclusion, 14 (87.5%) of whom had minimum 5-year follow-up, with a mean of 68.8 months (range, 60.1-79.6 months). The study group consisted of 13 women (92.9%) and 1 man (7.1%) with a mean age at surgery of 57.4 years (range, 46.3-74.8 years). Outcome scores improved as follows: modified Harris Hip Score, from 52.4 to 81.2 (P = .004); Non-Arthritic Hip Score, from 48.0 to 82.5 (P = .002); Hip Outcome Score-Sports Specific Subscale, from 30.1 to 66.4 (P < .001); and visual analog scale score, from 6.2 to 2.6 (P = .001). At minimum 5-year follow-up, the mean iHOT-12 score was 73.8 and the mean patient satisfaction rating was 8.4. Survivorship was 92.9%, with 1 patient who underwent conversion to total hip arthroplasty. There was no deterioration in patient outcomes and satisfaction between 2 and 5 years postoperatively. There were no clinical failures of gluteus medius repair and no complications. Endoscopic gluteus medius repair with concomitant hip arthroscopy for labral

  16. Detailed Distribution Map of Absorbed Dose Rate in Air in Tokatsu Area of Chiba Prefecture, Japan, Constructed by Car-Borne Survey 4 Years after the Fukushima Daiichi Nuclear Power Plant Accident.

    PubMed

    Inoue, Kazumasa; Arai, Moeko; Fujisawa, Makoto; Saito, Kyouko; Fukushi, Masahiro

    2017-01-01

    A car-borne survey was carried out in the northwestern, or Tokatsu, area of Chiba Prefecture, Japan, to make a detailed distribution map of absorbed dose rate in air four years after the Fukushima Daiichi Nuclear Power Plant accident. This area was chosen because it was the most heavily radionuclide contaminated part of Chiba Prefecture and it neighbors metropolitan Tokyo. Measurements were performed using a 3-in × 3-in NaI(Tl) scintillation spectrometer in June 2015. The survey route covered the whole Tokatsu area which includes six cities. A heterogeneous distribution of absorbed dose rate in air was observed on the dose distribution map. Especially, higher absorbed dose rates in air exceeding 80 nGy h-1 were observed along national roads constructed using high porosity asphalt, whereas lower absorbed dose rates in air were observed along local roads constructed using low porosity asphalt. The difference between these asphalt types resulted in a heterogeneous dose distribution in the Tokatsu area. The mean of the contribution ratio of artificial radionuclides to absorbed dose rate in air measured 4 years after the accident was 29% (9-50%) in the Tokatsu area. The maximum absorbed dose rate in air, 201 nGy h-1 was observed at Kashiwa City. Radiocesium was deposited in the upper 1 cm surface layer of the high porosity asphalt which was collected in Kashiwa City and the environmental half-life of the absorbed dose rate in air was estimated to be 1.7 years.

  17. Detailed Distribution Map of Absorbed Dose Rate in Air in Tokatsu Area of Chiba Prefecture, Japan, Constructed by Car-Borne Survey 4 Years after the Fukushima Daiichi Nuclear Power Plant Accident

    PubMed Central

    Inoue, Kazumasa; Arai, Moeko; Fujisawa, Makoto; Saito, Kyouko; Fukushi, Masahiro

    2017-01-01

    A car-borne survey was carried out in the northwestern, or Tokatsu, area of Chiba Prefecture, Japan, to make a detailed distribution map of absorbed dose rate in air four years after the Fukushima Daiichi Nuclear Power Plant accident. This area was chosen because it was the most heavily radionuclide contaminated part of Chiba Prefecture and it neighbors metropolitan Tokyo. Measurements were performed using a 3-in × 3-in NaI(Tl) scintillation spectrometer in June 2015. The survey route covered the whole Tokatsu area which includes six cities. A heterogeneous distribution of absorbed dose rate in air was observed on the dose distribution map. Especially, higher absorbed dose rates in air exceeding 80 nGy h-1 were observed along national roads constructed using high porosity asphalt, whereas lower absorbed dose rates in air were observed along local roads constructed using low porosity asphalt. The difference between these asphalt types resulted in a heterogeneous dose distribution in the Tokatsu area. The mean of the contribution ratio of artificial radionuclides to absorbed dose rate in air measured 4 years after the accident was 29% (9–50%) in the Tokatsu area. The maximum absorbed dose rate in air, 201 nGy h-1 was observed at Kashiwa City. Radiocesium was deposited in the upper 1 cm surface layer of the high porosity asphalt which was collected in Kashiwa City and the environmental half-life of the absorbed dose rate in air was estimated to be 1.7 years. PMID:28129382

  18. High throughput light absorber discovery, Part 2: Establishing structure–band gap energy relationships

    DOE PAGES

    Suram, Santosh K.; Newhouse, Paul F.; Zhou, Lan; ...

    2016-09-23

    Combinatorial materials science strategies have accelerated materials development in a variety of fields, and we extend these strategies to enable structure-property mapping for light absorber materials, particularly in high order composition spaces. High throughput optical spectroscopy and synchrotron X-ray diffraction are combined to identify the optical properties of Bi-V-Fe oxides, leading to the identification of Bi 4V 1.5Fe 0.5O 10.5 as a light absorber with direct band gap near 2.7 eV. Here, the strategic combination of experimental and data analysis techniques includes automated Tauc analysis to estimate band gap energies from the high throughput spectroscopy data, providing an automated platformmore » for identifying new optical materials.« less

  19. High throughput light absorber discovery, Part 2: Establishing structure–band gap energy relationships

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Suram, Santosh K.; Newhouse, Paul F.; Zhou, Lan

    Combinatorial materials science strategies have accelerated materials development in a variety of fields, and we extend these strategies to enable structure-property mapping for light absorber materials, particularly in high order composition spaces. High throughput optical spectroscopy and synchrotron X-ray diffraction are combined to identify the optical properties of Bi-V-Fe oxides, leading to the identification of Bi 4V 1.5Fe 0.5O 10.5 as a light absorber with direct band gap near 2.7 eV. Here, the strategic combination of experimental and data analysis techniques includes automated Tauc analysis to estimate band gap energies from the high throughput spectroscopy data, providing an automated platformmore » for identifying new optical materials.« less

  20. 2D Homologous Perovskites as Light-Absorbing Materials for Solar Cell Applications.

    PubMed

    Cao, Duyen H; Stoumpos, Constantinos C; Farha, Omar K; Hupp, Joseph T; Kanatzidis, Mercouri G

    2015-06-24

    We report on the fabrication and properties of the semiconducting 2D (CH3(CH2)3NH3)2(CH3NH3)(n-1)Pb(n)I(3n+1) (n = 1, 2, 3, and 4) perovskite thin films. The band gaps of the series decrease with increasing n values, from 2.24 eV (CH3(CH2)3NH3)2PbI4 (n = 1) to 1.52 eV CH3NH3PbI3 (n = ∞). The compounds exhibit strong light absorption in the visible region, accompanied by strong photoluminescence at room temperature, rendering them promising light absorbers for photovoltaic applications. Moreover, we find that thin films of the semi-2D perovskites display an ultrahigh surface coverage as a result of the unusual film self-assembly that orients the [Pb(n)I(3n+1)](-) layers perpendicular to the substrates. We have successfully implemented this 2D perovskite family in solid-state solar cells, and obtained an initial power conversion efficiency of 4.02%, featuring an open-circuit voltage (V(oc)) of 929 mV and a short-circuit current density (J(sc)) of 9.42 mA/cm(2) from the n = 3 compound. This result is even more encouraging considering that the device retains its performance after long exposure to a high-humidity environment. Overall, the homologous 2D halide perovskites define a promising class of stable and efficient light-absorbing materials for solid-state photovoltaics and other applications.

  1. Two-Year Outcomes of Surgical Treatment of Moderate Ischemic Mitral Regurgitation.

    PubMed

    Michler, Robert E; Smith, Peter K; Parides, Michael K; Ailawadi, Gorav; Thourani, Vinod; Moskowitz, Alan J; Acker, Michael A; Hung, Judy W; Chang, Helena L; Perrault, Louis P; Gillinov, A Marc; Argenziano, Michael; Bagiella, Emilia; Overbey, Jessica R; Moquete, Ellen G; Gupta, Lopa N; Miller, Marissa A; Taddei-Peters, Wendy C; Jeffries, Neal; Weisel, Richard D; Rose, Eric A; Gammie, James S; DeRose, Joseph J; Puskas, John D; Dagenais, François; Burks, Sandra G; El-Hamamsy, Ismail; Milano, Carmelo A; Atluri, Pavan; Voisine, Pierre; O'Gara, Patrick T; Gelijns, Annetine C

    2016-05-19

    In a trial comparing coronary-artery bypass grafting (CABG) alone with CABG plus mitral-valve repair in patients with moderate ischemic mitral regurgitation, we found no significant difference in the left ventricular end-systolic volume index (LVESVI) or survival after 1 year. Concomitant mitral-valve repair was associated with a reduced prevalence of moderate or severe mitral regurgitation, but patients had more adverse events. We now report 2-year outcomes. We randomly assigned 301 patients to undergo either CABG alone or the combined procedure. Patients were followed for 2 years for clinical and echocardiographic outcomes. At 2 years, the mean (±SD) LVESVI was 41.2±20.0 ml per square meter of body-surface area in the CABG-alone group and 43.2±20.6 ml per square meter in the combined-procedure group (mean improvement over baseline, -14.1 ml per square meter and -14.6 ml per square meter, respectively). The rate of death was 10.6% in the CABG-alone group and 10.0% in the combined-procedure group (hazard ratio in the combined-procedure group, 0.90; 95% confidence interval, 0.45 to 1.83; P=0.78). There was no significant between-group difference in the rank-based assessment of the LVESVI (including death) at 2 years (z score, 0.38; P=0.71). The 2-year rate of moderate or severe residual mitral regurgitation was higher in the CABG-alone group than in the combined-procedure group (32.3% vs. 11.2%, P<0.001). Overall rates of hospital readmission and serious adverse events were similar in the two groups, but neurologic events and supraventricular arrhythmias remained more frequent in the combined-procedure group. In patients with moderate ischemic mitral regurgitation undergoing CABG, the addition of mitral-valve repair did not lead to significant differences in left ventricular reverse remodeling at 2 years. Mitral-valve repair provided a more durable correction of mitral regurgitation but did not significantly improve survival or reduce overall adverse events or

  2. Better Absorbents for Ammonia Separation

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Malmali, Mahdi; Le, Giang; Hendrickson, Jennifer

    Making ammonia from renewable wind energy at a competitive price may be possible if the conventional ammonia condenser is replaced with an ammonia absorber. Such a process change requires an ammonia selective absorbent. Supported metal halide sorbents for this separation display outstanding dynamic capacity close to their equilibrium thermodynamic limits. Alkaline earth chlorides and bromides supported on silica and zeolite Y are the most promising. MgCl 2 and CaBr 2 at 40% loading on silica show capacities of 60-70 mg NH3/gsorbent at 150 °C and 4 bar. Overall, cations with smaller atomic numbers show more affinity to ammonia; bromides holdmore » ammonia more strongly than chlorides. Different solvents and metal halide mixtures do not show significant changes in the absorption capacity. Finally, these absorbents can be incorporated into ammonia reaction-absorption syntheses to achieve faster production rates.« less

  3. Better Absorbents for Ammonia Separation

    DOE PAGES

    Malmali, Mahdi; Le, Giang; Hendrickson, Jennifer; ...

    2018-03-30

    Making ammonia from renewable wind energy at a competitive price may be possible if the conventional ammonia condenser is replaced with an ammonia absorber. Such a process change requires an ammonia selective absorbent. Supported metal halide sorbents for this separation display outstanding dynamic capacity close to their equilibrium thermodynamic limits. Alkaline earth chlorides and bromides supported on silica and zeolite Y are the most promising. MgCl 2 and CaBr 2 at 40% loading on silica show capacities of 60-70 mg NH3/gsorbent at 150 °C and 4 bar. Overall, cations with smaller atomic numbers show more affinity to ammonia; bromides holdmore » ammonia more strongly than chlorides. Different solvents and metal halide mixtures do not show significant changes in the absorption capacity. Finally, these absorbents can be incorporated into ammonia reaction-absorption syntheses to achieve faster production rates.« less

  4. The Norwegian Cervical Arthroplasty Trial (NORCAT): 2-year clinical outcome after single-level cervical arthroplasty versus fusion-a prospective, single-blinded, randomized, controlled multicenter study.

    PubMed

    Sundseth, Jarle; Fredriksli, Oddrun Anita; Kolstad, Frode; Johnsen, Lars Gunnar; Pripp, Are Hugo; Andresen, Hege; Myrseth, Erling; Müller, Kay; Nygaard, Øystein P; Zwart, John-Anker

    2017-04-01

    Standard surgical treatment for symptomatic cervical disc disease has been discectomy and fusion, but the use of arthroplasty, designed to preserve motion, has increased, and most studies report clinical outcome in its favor. Few of these trials, however, blinded the patients. We, therefore, conducted the Norwegian Cervical Arthroplasty Trial, and present 2-year clinical outcome after arthroplasty or fusion. This multicenter trial included 136 patients with single-level cervical disc disease. The patients were randomized to arthroplasty or fusion, and blinded to the treatment modality. The surgical team was blinded to randomization until nerve root decompression was completed. Primary outcome was the self-rated Neck Disability Index. Secondary outcomes were the numeric rating scale for pain and quality of life questionnaires Short Form-36 and EuroQol-5Dimension-3 Level. There was a significant improvement in the primary and all secondary outcomes from baseline to 2-year follow-up for both arthroplasty and fusion (P < 0.001), and no observed significant between-group differences at any follow-up times. However, linear mixed model analyses, correcting for baseline values, dropouts and missing data, revealed a difference in Neck Disability Index (P = 0.049), and arm pain (P = 0.027) in favor of fusion at 2 years. The duration of surgery was longer (P < 0.001), and the frequency of reoperations higher (P = 0.029) with arthroplasty. The present study showed excellent clinical results and no significant difference between treatments at any scheduled follow-up. However, the rate of index level reoperations was higher and the duration of surgery longer with arthroplasty. http://www.clinicaltrials.gov NCT 00735176.19.

  5. Report of the Clinical and Functional Primary Outcomes in Men of the ACL-SPORTS Trial: Similar Outcomes in Men Receiving Secondary Prevention With and Without Perturbation Training 1 and 2 Years After ACL Reconstruction.

    PubMed

    Arundale, Amelia J H; Cummer, Kathleen; Capin, Jacob J; Zarzycki, Ryan; Snyder-Mackler, Lynn

    2017-10-01

    Athletes often are cleared to return to activities 6 months after anterior cruciate ligament (ACL) reconstruction; however, knee function measures continue to improve up to 2 years after surgery. Interventions beyond standard care may facilitate successful return to preinjury activities and improve functional outcomes. Perturbation training has been used in nonoperative ACL injury and preoperative ACL reconstruction rehabilitation, but has not been examined in postoperative ACL reconstruction rehabilitation, specifically return to sport rehabilitation. The purpose of this study was to determine whether there were differences at 1 and 2 years after ACL reconstruction between the male SAP (strengthening, agility, and secondary prevention) and SAP+PERT (SAP protocol with the addition of perturbation training) groups with respect to (1) quadriceps strength and single-legged hop limb symmetry; (2) patient-reported knee outcome scores; (3) the proportion who achieve self-reported normal knee function; and (4) the time from surgery to passing return to sport criteria. Forty men who had completed ACL reconstruction rehabilitation and met enrollment criteria (3-9 months after ACL reconstruction, > 80% quadriceps strength limb symmetry, no pain, full ROM, minimal effusion) were randomized into the SAP or SAP+PERT groups of the Anterior Cruciate Ligament-Specialised Post-Operative Return to Sports trial (ACL-SPORTS), a single-blind randomized clinical study of secondary prevention and return to sport. Quadriceps strength, single-legged hopping, the International Knee Documentation Committee (IKDC) 2000 subjective knee form, Knee Injury and Osteoarthritis Outcome Score (KOOS)-sports and recreation, and KOOS-quality-of-life subscales were collected 1 and 2 years after surgery by investigators blind to group. Athletes were categorized as having normal or abnormal knee function at each time point based on IKDC score, and the time until athletes passed strict return

  6. Alternative Caries Management Options for Primary Molars: 2.5-Year Outcomes of a Randomised Clinical Trial.

    PubMed

    Santamaría, Ruth M; Innes, N P T; Machiulskiene, Vita; Schmoeckel, Julian; Alkilzy, Mohammad; Splieth, Christian H

    2017-12-20

    Less invasive caries management techniques for treating cavitated carious primary teeth, which involve the concept of caries control by managing the activity of the biofilm, are becoming common. This study aimed to compare the clinical efficacy (minor/major failures) and survival rates (successful cases without any failures) of 3 carious lesion treatment approaches, the Hall Technique (HT), non-restorative caries treatment (NRCT), and conventional restorations (CR), for the management of occlusoproximal caries lesions (ICDAS 3-5) in primary molars. Results at 2.5 years are presented. A total of 169 children (3- to 8-year-olds) were enrolled in this secondary care-based, 3-arm parallel-group, randomised controlled trial. Participants were allocated to: HT (n = 52; sealing caries with stainless-steel crowns without caries removal), NRCT (n = 52; opening up the cavity and applying fluoride varnish), CR (n = 65; control arm, complete caries removal and compomer restoration). Statistical analyses were: non-parametric Kruskal-Wallis analysis of variance, Mann-Whitney U test and Kaplan-Meier survival analyses. One hundred and forty-two participants (84%; HT = 40/52; NRCT = 44/52; CR = 58/65) had follow-up data of 1-33 months (mean = 26). Overall, 25 (HT = 2, NRCT = 9, CR = 14) of 142 participants (17.6%) presented with at least 1 minor failure (reversible pulpitis, caries progression, or secondary caries; p = 0.013, CI = 0.012-0.018; Mann-Whitney U test). Ten (HT = 1, NRCT = 4, CR = 5) of 142 participants (7.04%) experienced at least 1 major failure (irreversible pulpitis, abscess, unrestorable tooth; p = 0.043, CI = 0.034-0.045). Independent comparisons between 2 samples found that NRCT-CR had no statistically significant difference in failures (p > 0.05), but for CR-HT (p = 0.037, CI = 0.030-0.040) and for NRCT-HT (p = 0.011, CI = 0.010-0.016; Kruskal-Wallis test) significant differences were observed. Cumulative survival rates were HT = 92.5%, NRCT = 70.5%, and CR = 67.2

  7. Long-term outcomes five years after selective dorsal rhizotomy

    PubMed Central

    Nordmark, Eva; Josenby, Annika Lundkvist; Lagergren, Jan; Andersson, Gert; Strömblad, Lars-Göran; Westbom, Lena

    2008-01-01

    Background Selective dorsal rhizotomy (SDR) is a well accepted neurosurgical procedure performed for the relief of spasticity interfering with motor function in children with spastic cerebral palsy (CP). The goal is to improve function, but long-term outcome studies are rare. The aims of this study were to evaluate long-term functional outcomes, safety and side effects during five postoperative years in all children with diplegia undergoing SDR combined with physiotherapy. Methods This study group consisted of 35 children, consecutively operated, with spastic diplegia, of which 26 were Gross Motor Function Classification System (GMFCS) levels III–V. Mean age was 4.5 years (range 2.5–6.6). They were all assessed by the same multidisciplinary team at pre- and at 6, 12, 18 months, 3 and 5 years postoperatively. Clinical and demographic data, complications and number of rootlets cut were prospectively registered. Deep tendon reflexes and muscle tone were examined, the latter graded with the modified Ashworth scale. Passive range of motion (PROM) was measured with a goniometer. Motor function was classified according to the GMFCS and measured with the Gross Motor Function Measure (GMFM-88) and derived into GMFM-66. Parent's opinions about the children's performance of skills and activities and the amount of caregiver assistance were measured with Pediatric Evaluation Disability Inventory (PEDI). Results The mean proportion of rootlets cut in S2-L2 was 40%. Muscle tone was immediately reduced in adductors, hamstrings and dorsiflexors (p < 0.001) with no recurrence of spasticity over the 5 years. For GMFCS-subgroups I–II, III and IV–V significant improvements during the five years were seen in PROM for hip abduction, popliteal angle and ankle dorsiflexion (p = 0.001), capacity of gross motor function (GMFM) (p = 0.001), performance of functional skills and independence in self-care and mobility (PEDI) (p = 0.001). Conclusion SDR is a safe and effective method for

  8. Non-absorbed Antibiotics for IBS

    DTIC Science & Technology

    2012-03-16

    absorbed antibiotic rifaximin for nonconstipated irritable bowel syndrome (IBS). This effort adds to the body of literature from other, smaller studies that...have demonstrated clinical efficacy for IBS with rifaximin . Non-absorbed antibiotics have been endorsed by the American College of Gastroenterology... rifaximin 400 mg three times daily for 10 days or placebo. During the initial 2 weeks of therapy and the subsequent 10 weeks of follow-up rifaximin

  9. Absorbent product to absorb fluids. [for collection of human wastes

    NASA Technical Reports Server (NTRS)

    Dawn, F. S.; Correale, J. V. (Inventor)

    1982-01-01

    A multi-layer absorbent product for use in contact with the skin to absorb fluids is discussed. The product utilizes a water pervious facing layer for contacting the skin, overlayed by a first fibrous wicking layer, the wicking layer preferably being of the one-way variety in which fluid or liquid is moved away from the facing layer. The product further includes a first container section defined by inner and outer layer of a water pervious wicking material between which is disposed a first absorbent mass. A second container section defined by inner and outer layers between which is disposed a second absorbent mass and a liquid impermeable/gas permeable layer. Spacesuit applications are discussed.

  10. Dental Enamel Irradiated with Infrared Diode Laser and Photo-Absorbing Cream: Part 2—EDX Study

    PubMed Central

    dos Santos, Edson Aparecido Pereira; Soares, Luís Eduardo Silva; do Espírito Santo, Ana Maria; Martin, Airton Abrahão; Duarte, Danilo Antônio; Pacheco-Soares, Cristina; Brugnera, Aldo

    2009-01-01

    Abstract Objective: The effects of laser-induced compositional changes on the enamel were investigated by energy-dispersive X-ray fluorescence spectrometry (μ-EDX). After cariogenic challenge, we administered treatment of low-level infrared diode laser and a photo-absorbing cream (used to intensify the superficial light absorption). Background Data: Dental caries is considered the most prevalent oral disease. A simple and noninvasive caries preventive regimen is treating tooth enamel with a laser, either alone or in combination with fluoride, which reduces enamel solubility and dissolution rates. High power lasers are still not widely used in private practice. Low-power near-infrared lasers may be an alternative approach. Energy-dispersive μ-EDX is a versatile and nondestructive spectroscopic technique that allows for a qualitative and quantitative elemental analysis of inorganic enamel components, such as calcium and phosphorus. Materials and Methods: Twenty-four extracted or exfoliated caries-free deciduous molars were divided into six groups: 1) control group (CTR-no treatment); 2) infrared laser treatment (L) (λ = 810 nm, 100 mW/cm2, 90 sec, 4.47 J/cm2, 9 J); 3) infrared laser irradiation and photo-absorbing agent (CL); 4) photo-absorbing agent alone (C); 5) infrared laser irradiation and fluoridated photo-absorbing agent (FCL); and 6) fluoridated photo-absorbing agent alone (FC). Samples were analyzed using μ-EDX after two sets of treatments and pH cycling cariogenic challenges. Results: The CL group showed statistically significant increases in calcium and phosphorus (wt%) compared with the CTR group. The Ca/P ratio was similar in the FCL and CTR groups. There was a significant laser-induced reduction compared with the CTR group, and there was a possible modification of the organic balance content in enamel treated with laser and cream. Conclusion: μ-EDX may be able to detect compositional changes in mineral phases of lased enamel under

  11. Language Outcomes at 7 Years: Early Predictors and Co-Occurring Difficulties.

    PubMed

    McKean, Cristina; Reilly, Sheena; Bavin, Edith L; Bretherton, Lesley; Cini, Eileen; Conway, Laura; Cook, Fallon; Eadie, Patricia; Prior, Margot; Wake, Melissa; Mensah, Fiona

    2017-03-01

    To examine at 7 years the language abilities of children, the salience of early life factors and language scores as predictors of language outcome, and co-occurring difficulties METHODS: A longitudinal cohort study of 1910 infants recruited at age 8 to 10 months. Exposures included early life factors (sex, prematurity, birth weight/order, twin birth, socioeconomic status, non-English speaking background,family history of speech/language difficulties); maternal factors (mental health, vocabulary, education, and age); and child language ability at 2 and 4 years. Outcomes were 7-year standardized receptive or expressive language scores (low language: ≥1.25 SD below the mean), and co-occurring difficulties (autism, literacy, social, emotional, and behavioral adjustment, and health-related quality of life). Almost 19% of children (22/1204;18.9%) met criteria for low language at 7 years. Early life factors explained 9-13% of variation in language scores, increasing to 39-58% when child language scores at ages 2 and 4 were included. Early life factors moderately discriminated between children with and without low language (area under the curve: 0.68-0.72), strengthening to good discrimination with language scores at ages 2 and 4 (area under the curve: 0.85-0.94). Low language at age 7 was associated with concurrent difficulties in literacy, social-emotional and behavioral difficulties, and limitations in school and psychosocial functioning. Child language ability at 4 years more accurately predicted low language at 7 than a range of early child, family, and environmental factors. Low language at 7 years was associated with a higher prevalence of co-occurring difficulties. Copyright © 2017 by the American Academy of Pediatrics.

  12. Does duration of symptoms affect clinical outcome after hip arthroscopy for labral tears? Analysis of prospectively collected outcomes with minimum 2-year follow-up

    PubMed Central

    Ni, Jake; Hohn, Eric A; Domb, Benjamin G

    2017-01-01

    Abstract Limited research exists on the possible association between duration of symptoms and clinical outcomes following hip arthroscopy for labral tears. The purpose of this study was to evaluate whether duration of symptoms affected clinical and patient-reported outcome (PRO) scores following hip arthroscopy for labral tears. From 2008 to 2011, data were collected prospectively on all patients undergoing primary hip arthroscopy for labral tears. Workers’ compensation cases, dysplasia cases and patients with previous ipsilateral hip surgeries were excluded. A total of 738 patients were identified with a minimum of 2-year follow-up, and clinical and PRO data were available for 680 patients. Uni- and multivariate analyses were performed to determine the relationship between duration of symptoms along with other variables and PROs. Overall, patients experienced significant improvements in all clinical and PRO scores. Results of univariate analysis revealed that all PROs were negatively associated with increasing Log10 months of symptoms as were pain and satisfaction scores. During multivariate analyses, increasing Log10 months of symptoms, age, body mass index and trauma were all negatively associated with PROs (P  < 0.05). Our study demonstrates that clinical and PRO scores were negatively associated with increasing duration of symptoms prior to hip arthroscopy for treatment of labral tears. Although this implies that delay in treatment may adversely affect outcome, conservative treatment remains the gold standard first line of treatment. Surgeons should incorporate this information into their treatment algorithm to maximize patient outcomes following treatment for labral tears. Level of evidence: Level IV, prospective case series. PMID:29250339

  13. Abnormal sensory reactivity in preterm infants during the first year correlates with adverse neurodevelopmental outcomes at 2 years of age.

    PubMed

    Chorna, Olena; Solomon, Jessica E; Slaughter, James C; Stark, Ann R; Maitre, Nathalie L

    2014-11-01

    Sensory experience is the basis for learning in infancy. In older children, abnormal sensory reactivity is associated with behavioural and developmental disorders. We hypothesised that in preterm infants, abnormal sensory reactivity during infancy would be associated with perinatal characteristics and correlate with 2-year neurodevelopmental outcomes. We conducted a prospective observational study of infants with birth weight ≤1500 g using the Test of Sensory Function in Infants (TSFI) in the first year. Infants with gestational age ≤30 weeks were tested with the Bayley Scales of Infant and Toddler Development III (BSID III) at 24 months. Of the 72 participants evaluated at 4-12 months corrected age (median 8 months), 59 (82%) had a least one TSFI score concerning for abnormal sensory reactivity. Lower gestational age was associated with abnormal reactivity to deep pressure and vestibular stimulation (p<0.001). Poor ocular-motor control predicted worse cognitive and motor scores in early childhood (OR 16.7; p=0.004), but was tightly correlated to the presence of severe white matter injury. Poor adaptive motor function in response to tactile stimuli predicted worse BSID III motor (p=0.01) and language scores (p=0.04) at 2years, even after adjusting for confounders. Abnormal sensory reactivity is common in preterm infants; is associated with immaturity at birth, severe white matter injury and lower primary caregiver education; and predicts neurodevelopmental delays. Early identification of abnormal sensory reactivity of very preterm infants may promote parental support and education and may facilitate improved neurodevelopment. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  14. Externally tuned vibration absorber

    DOEpatents

    Vincent, Ronald J.

    1987-09-22

    A vibration absorber unit or units are mounted on the exterior housing of a hydraulic drive system of the type that is powered from a pressure wave generated, e.g., by a Stirling engine. The hydraulic drive system employs a piston which is hydraulically driven to oscillate in a direction perpendicular to the axis of the hydraulic drive system. The vibration absorbers each include a spring or other resilient member having one side affixed to the housing and another side to which an absorber mass is affixed. In a preferred embodiment, a pair of vibration absorbers is employed, each absorber being formed of a pair of leaf spring assemblies, between which the absorber mass is suspended.

  15. Highly efficient special sound absorbing solutions

    NASA Technical Reports Server (NTRS)

    Ionescu, M.; Petre-Lazar, S.

    1974-01-01

    Highly efficient special sound absorbing structures with the following criteria are considered: (1) A distribution surface of the sound absorbing material greater than that of the building element on which the structure is placed; (2) The highest possible absorption coefficient in the widest possible frequency band; and (3) adaptability to different construction and aesthetic conditions.

  16. Can items used in 4-year-old well-child visits predict children's health and school outcomes?

    PubMed

    Smithers, Lisa G; Chittleborough, Catherine R; Stocks, Nigel; Sawyer, Michael G; Lynch, John W

    2014-08-01

    To examine whether items comprising a preschool well-child check for use by family doctors in Australia with 4-5-year old children predicts health and academic outcomes at 6-7 years. The well-child check includes mandatory (anthropometry, eye/vision, ear/hearing, dental, toileting, allergy problems) and non-mandatory (processed food consumption, low physical activity, motor, behaviour/mood problems) items. The predictive validity of mandatory and non-mandatory items measured at 4-5 years was examined using data from the Longitudinal Study of Australian Children. Outcomes at 6-7 years included overweight/obesity, asthma, health care/medication needs, general health, mental health problems, quality of life, teacher-reported mathematics and literacy ability (n = 2,280-2,787). Weight or height >90th centile at 4-5 years predicted overweight/obesity at 6-7 years with 60% sensitivity, 79% specificity and 40% positive predictive value (PPV). Mood/behaviour problems at 4-5 predicted mental health problems at 6-7 years with 86% sensitivity, 40% specificity and 8% PPV. Non-mandatory items improved the discrimination between children with and without mental health problems at 6-7 years (area under the receiver operating characteristic curve 0.75 compared with 0.69 for mandatory items only), but was weak for most outcomes. Items used in a well-child health check were moderate predictors of overweight/obesity and mental health problems at 6-7 years, but poor predictors of other health and academic outcomes.

  17. Methods for absorbing neutrons

    DOEpatents

    Guillen, Donna P [Idaho Falls, ID; Longhurst, Glen R [Idaho Falls, ID; Porter, Douglas L [Idaho Falls, ID; Parry, James R [Idaho Falls, ID

    2012-07-24

    A conduction cooled neutron absorber may include a metal matrix composite that comprises a metal having a thermal neutron cross-section of at least about 50 barns and a metal having a thermal conductivity of at least about 1 W/cmK. Apparatus for providing a neutron flux having a high fast-to-thermal neutron ratio may include a source of neutrons that produces fast neutrons and thermal neutrons. A neutron absorber positioned adjacent the neutron source absorbs at least some of the thermal neutrons so that a region adjacent the neutron absorber has a fast-to-thermal neutron ratio of at least about 15. A coolant in thermal contact with the neutron absorber removes heat from the neutron absorber.

  18. Neurobehavioral Outcomes 11 Years After Neonatal Caffeine Therapy for Apnea of Prematurity.

    PubMed

    Mürner-Lavanchy, Ines M; Doyle, Lex W; Schmidt, Barbara; Roberts, Robin S; Asztalos, Elizabeth V; Costantini, Lorrie; Davis, Peter G; Dewey, Deborah; D'Ilario, Judy; Grunau, Ruth E; Moddemann, Diane; Nelson, Harvey; Ohlsson, Arne; Solimano, Alfonso; Tin, Win; Anderson, Peter J

    2018-05-01

    Caffeine is effective in the treatment of apnea of prematurity. Although caffeine therapy has a benefit on gross motor skills in school-aged children, effects on neurobehavioral outcomes are not fully understood. We aimed to investigate effects of neonatal caffeine therapy in very low birth weight (500-1250 g) infants on neurobehavioral outcomes in 11-year-old participants of the Caffeine for Apnea of Prematurity trial. Thirteen academic hospitals in Canada, Australia, Great Britain, and Sweden participated in this part of the 11-year follow-up of the double-blind, randomized, placebo-controlled trial. Measures of general intelligence, attention, executive function, visuomotor integration and perception, and behavior were obtained in up to 870 children. The effects of caffeine therapy were assessed by using regression models. Neurobehavioral outcomes were generally similar for both the caffeine and placebo group. The caffeine group performed better than the placebo group in fine motor coordination (mean difference [MD] = 2.9; 95% confidence interval [CI]: 0.7 to 5.1; P = .01), visuomotor integration (MD = 1.8; 95% CI: 0.0 to 3.7; P < .05), visual perception (MD = 2.0; 95% CI: 0.3 to 3.8; P = .02), and visuospatial organization (MD = 1.2; 95% CI: 0.4 to 2.0; P = .003). Neonatal caffeine therapy for apnea of prematurity improved visuomotor, visuoperceptual, and visuospatial abilities at age 11 years. General intelligence, attention, and behavior were not adversely affected by caffeine, which highlights the long-term safety of caffeine therapy for apnea of prematurity in very low birth weight neonates. Copyright © 2018 by the American Academy of Pediatrics.

  19. Kidney outcomes three years after bariatric surgery in severely obese adolescents.

    PubMed

    Nehus, Edward J; Khoury, Jane C; Inge, Thomas H; Xiao, Nianzhou; Jenkins, Todd M; Moxey-Mims, Marva M; Mitsnefes, Mark M

    2017-02-01

    A significant number of severely obese adolescents undergoing bariatric surgery have evidence of early kidney damage. To determine if kidney injury is reversible following bariatric surgery, we investigated renal outcomes in the Teen-Longitudinal Assessment of Bariatric Surgery cohort, a prospective multicenter study of 242 severely obese adolescents undergoing bariatric surgery. Primary outcomes of urine albumin-to-creatinine ratio and cystatin C-based estimated glomerular filtration rate (eGFR) were evaluated preoperatively and up to 3 years following bariatric surgery. At surgery, mean age of participants was 17 years and median body mass index (BMI) was 51 kg/m 2 . In those with decreased kidney function at baseline (eGFR under 90 mL/min/1.73m 2 ), mean eGFR significantly improved from 76 to 102 mL/min/1.73m 2 at three-year follow-up. Similarly, participants with albuminuria (albumin-to-creatinine ratio of 30 mg/g and more) at baseline demonstrated significant improvement following surgery: geometric mean of ACR was 74 mg/g at baseline and decreased to 17 mg/g at three years. Those with normal renal function and no albuminuria at baseline remained stable throughout the study period. Among individuals with a BMI of 40 kg/m 2 and more at follow-up, increased BMI was associated with significantly lower eGFR, while no association was observed in those with a BMI under 40 kg/m 2 . In adjusted analysis, eGFR increased by 3.9 mL/min/1.73m 2 for each 10-unit loss of BMI. Early kidney abnormalities improved following bariatric surgery in adolescents with evidence of preoperative kidney disease. Thus, kidney disease should be considered as a selection criteria for bariatric surgery in severely obese adolescents who fail conventional weight management. Copyright © 2016 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.

  20. Meniscal Repair with Concurrent Anterior Cruciate Ligament Reconstruction: Operative Success and Patient Outcomes at 6-Year Follow-up

    PubMed Central

    Westermann, RW; Wright, RW; Huston, LJ; Wolf, BR

    2015-01-01

    BACKGROUND Meniscus repairs are commonly performed concurrently with anterior cruciate ligament reconstruction (ACLR) in the acutely injured knee. No large-scale, prospective, multicenter studies have evaluated long-term success and patient-oriented outcomes after combined ACLR and meniscus repair. PURPOSE To define operative success and patient-oriented outcome scores 6 years after combined meniscus repair and ACLR. STUDY DESIGN Cohort study; Level of evidence, 3. METHODS All ipsilateral primary ACLR and meniscus repair cases from a multicenter study group between 2002 and 2004 were selected. Validated patient-oriented outcome instruments were completed at 3 time points: preoperatively, 2 years and 6 years following the index procedure. Subsequent ipsilateral knee re-operation was confirmed by operative reports to evaluate for failure of meniscal repairs. RESULTS In total, 286 patients of 1440 primary ACLR’s underwent concurrent meniscus repair (298 meniscal repairs). 235/286 (82.2%) were available for follow-up at 6 years (154 medial, 72 lateral and 9 both lateral and medial meniscal repairs). Repaired menisci most commonly involved the peripheral 1/3 of the meniscus (84%); patterns were typically longitudinal (84%) or displaced bucket-handle (10%), with mean length of 16.5 ±5.8mm. Overall, the meniscal repair failure rate was 14% (medial, 21/154; lateral, 10/72; both 2/9) at 6 years. Medial repairs failed earlier than lateral repairs (2.1 versus 3.7 years; p=0.01). Significant improvements in outcome instruments were sustained at 6-year follow-up. No differences in suture number or type were detected between repair failures and successes. Meniscal reoperation was higher in patients who underwent repair compared to those who did have an identified meniscal injury at the time of ACLR (p<0.01). CONCLUSIONS Concurrent meniscal repair with ACLR is associated with failure rates approximating 14% at 6-year follow-up. Improvements in patient-oriented outcome

  1. Clinical profile and treatment outcome of older (>75 years) patients with systemic AL amyloidosis

    PubMed Central

    Sachchithanantham, Sajitha; Offer, Mark; Venner, Christopher; Mahmood, Shameem A.; Foard, Darren; Rannigan, Lisa; Lane, Thirusha; Gillmore, Julian D.; Lachmann, Helen J.; Hawkins, Philip N.; Wechalekar, Ashutosh D.

    2015-01-01

    Systemic AL amyloidosis, a disease with improving outcomes using novel therapies, is increasingly recognized in the elderly but treatment and outcomes have not been systematically studied in this group of patients in whom comorbidities and frailty may compound morbidity and mortality. We report the outcomes of 295 patients with systemic AL amyloidosis ≥75 years seen at the UK National Amyloidosis Centre from 2005–2012. The median age was 78.5 years. The median overall survival was 20 months. Two hundred and thirty-eight patients received chemotherapy and 57 elected for supportive care only (overall survival – 24 and 8.4 months, respectively). On intention-to-treat analysis, 44% achieved a hematologic response including a very good partial response or better in 23%. The median overall survival was 6.2 years in patients achieving very good partial response or better at the 6-month landmark analysis and 1.5 years in non-responders. Factors independently indicating a poor prognosis were: cardiac involvement, performance status ≥2; systolic blood pressure <100 mmHg and, on landmark analysis, achieving less than a very good partial response. Treatment of systemic AL amyloidosis in the elderly is challenging. Deep clonal responses are associated with excellent survival and organ responses. Achieving a response to the first-line regimen appears particularly important as outcomes of non-responders are similar to those of untreated patients. Prospective trials with lower toxicity, outpatient treatment regimens are needed. PMID:26294730

  2. Wideband Aural Acoustic Absorbance Predicts Conductive Hearing Loss in Children

    PubMed Central

    Keefe, Douglas H.; Sanford, Chris A.; Ellison, John C.; Fitzpatrick, Denis F.; Gorga, Michael P.

    2013-01-01

    Objective This study tested the hypothesis that wideband aural absorbance predicts conductive hearing loss (CHL) in children medically classified as having otitis media with effusion. Design Absorbance was measured in the ear canal over frequencies from 0.25 to 8 kHz at ambient pressure or as a swept tympanogram. CHL was defined using criterion air-bone gaps of 20, 25 and 30 dB at octaves from 0.25 to 4 kHz. A likelihood-ratio predictor of CHL was constructed across frequency for ambient absorbance and across frequency and pressure for absorbance tympanometry. Performance was evaluated at individual frequencies and for any frequency at which a CHL was present. Study Sample Absorbance and conventional 226-Hz tympanograms were measured in children of age 3 to 8 years with CHL and with normal hearing. Results Absorbance was smaller at frequencies above 0.7 kHz in the CHL group than the control group. Based on the area under the receiver operating characteristic curve, wideband absorbance in ambient and tympanometric tests were significantly better predictors of CHL than tympanometric width, the best 226-Hz predictor. Accuracies of ambient and tympanometric wideband absorbance did not differ. Conclusions Absorbance accurately predicted CHL in children and was more accurate than conventional 226-Hz tympanometry. PMID:23072655

  3. Antenatal and postnatal growth and 5-year cognitive outcome in very preterm infants.

    PubMed

    Leppänen, Marika; Lapinleimu, Helena; Lind, Annika; Matomäki, Jaakko; Lehtonen, Liisa; Haataja, Leena; Rautava, Päivi

    2014-01-01

    To study how antenatal growth affects cognitive outcome in very preterm infants and to determine whether there is an association between growth in any particular time period between birth and 5 years of age and cognitive outcome. Small for gestational age (SGA) and non-SGA infants were analyzed separately, because antenatal growth may affect postnatal growth. Very low birth weight (<1501 g) infants born between 2001 and 2006 and infants born at <32 gestational weeks between 2004 and 2006 who were treated at Turku University Hospital (n = 181) were followed. Weight, length, and head circumference (HC) of the infants were measured at 9 time points between birth and 5 years. The growth was determined as a z score change between measurement points. Cognitive development was assessed at 5 years of age with the Wechsler Preschool and Primary Scales of Intelligence-Revised. The association between growth and full-scale IQ (FSIQ) was studied. Growth in length and height was not associated with 5-year cognitive outcome. However, weight (r = 0.18, P = .04) and HC growth (r = 0.25, P = .01) between birth and 2 years of corrected age correlated to FSIQ in non-SGA children. In SGA children, HC growth (r = 0.33, P = .03) around term age correlated to FSIQ. Cognitive outcome was similar in SGA and non-SGA very preterm infants. Growth affected cognition positively in both subgroups, but the critical time period was different.

  4. The outcome of apical microsurgery using MTA as the root-end filling material: 2- to 6-year follow-up study.

    PubMed

    Çalışkan, M K; Tekin, U; Kaval, M E; Solmaz, M C

    2016-03-01

    To evaluate the influence of various predictors on the healing outcome 2-6 years after apical microsurgery (AMS) using MTA as the root-end filling material. A total of 90 anterior teeth with asymptomatic persistent periradicular periodontitis of strictly endodontic origin that failed after either nonsurgical or surgical treatment were included. Surgery was completed under local anaesthesia using a standardized clinical protocol. Clinical and radiographic measures as well as the follow-up period were used to determine the healing outcome. For statistical analysis of the predictors, the outcome was dichotomized into healed cases and nonhealed cases. Odds ratios were calculated, and Pearson chi-square or Fisher's exact tests were used to analyse the data. Clinical and radiographic assessment of AMS revealed that 80% were healed, 14.4% were nonhealed, whilst 5.6% were judged to be uncertain. None of the various predictors investigated had a significant influence on the outcome of AMS. The results of this clinical study demonstrated that 80% of cases that received apical microsurgery healed when using MTA as the root-end filling material. © 2015 International Endodontic Journal. Published by John Wiley & Sons Ltd.

  5. Preschoolers with Autism Spectrum Disorder Followed for 2 Years: Those Who Gained and Those Who Lost the Most in Terms of Adaptive Functioning Outcome

    ERIC Educational Resources Information Center

    Hedvall, Åsa; Westerlund, Joakim; Fernell, Elisabeth; Norrelgen, Fritjof; Kjellmer, Liselotte; Olsson, Martina Barnevik; Carlsson, Lotta Höglund; Eriksson, Mats A.; Billstedt, Eva; Gillberg, Christopher

    2015-01-01

    Clinical predictors of 2-year outcome in preschoolers with ASD were studied in a population-based group of very young children with ASD (n = 208). Children who gained the most (n = 30) and lost the most (n = 23), i.e., increased or decreased their adaptive functioning outcome according to the Vineland Composite Score between study entry (T1) and…

  6. Composition for absorbing hydrogen

    DOEpatents

    Heung, L.K.; Wicks, G.G.; Enz, G.L.

    1995-05-02

    A hydrogen absorbing composition is described. The composition comprises a porous glass matrix, made by a sol-gel process, having a hydrogen-absorbing material dispersed throughout the matrix. A sol, made from tetraethyl orthosilicate, is mixed with a hydrogen-absorbing material and solidified to form a porous glass matrix with the hydrogen-absorbing material dispersed uniformly throughout the matrix. The glass matrix has pores large enough to allow gases having hydrogen to pass through the matrix, yet small enough to hold the particles dispersed within the matrix so that the hydrogen-absorbing particles are not released during repeated hydrogen absorption/desorption cycles.

  7. Composition for absorbing hydrogen

    DOEpatents

    Heung, Leung K.; Wicks, George G.; Enz, Glenn L.

    1995-01-01

    A hydrogen absorbing composition. The composition comprises a porous glass matrix, made by a sol-gel process, having a hydrogen-absorbing material dispersed throughout the matrix. A sol, made from tetraethyl orthosilicate, is mixed with a hydrogen-absorbing material and solidified to form a porous glass matrix with the hydrogen-absorbing material dispersed uniformly throughout the matrix. The glass matrix has pores large enough to allow gases having hydrogen to pass through the matrix, yet small enough to hold the particles dispersed within the matrix so that the hydrogen-absorbing particles are not released during repeated hydrogen absorption/desorption cycles.

  8. Q-switched Yb3+:YAG laser using plasmonic Cu2-xSe quantum dots as saturable absorbers

    NASA Astrophysics Data System (ADS)

    Wang, Yimeng; Zhan, Yi; Lee, Sooho; Wang, Li; Zhang, Xinping

    2018-04-01

    Cu2-xSe quantum dots (QDs) were synthesized by organometallic synthesis methods. Due to heavy self-doping, the Cu2-xSe QDs exhibit particle plasmon resonance in the near-infrared. Transient absorption spectroscopic investigation revealed strong nonlinear optical absorption and bleaching performance of the QDs under femtosecond pulse excitation, which enabled the Cu2-xSe QDs to be excellent saturable absorbers and applied in Q-switched or mode-locked lasers. A passively Q-switched Yb3+:YAG solid-state laser at 1.03 μm was achieved by coating Cu2-xSe QDs as saturable absorbers onto one of the output coupler of the V-shaped linear cavity.

  9. Coblation assisted transnasal endoscopic resection of nasopharyngeal cyst: 10 years experience and outcomes

    PubMed Central

    Wang, Qinying; Chen, Haihong; Wang, Shenqing

    2015-01-01

    Objectives: To determine the outcomes of coblation assisted transnasal endoscopic resection of nasopharyngeal cyst. Method: Retrospective chart review outcomes in 12 patients who underwent endoscopic resect cysts of the nasopharynx at our department between 2001 and 2010. Twelve patient, aged 28 to 71 years, with cysts of the nasopharynx. The outcome variables of complications and the rate of recurrence were analyzed, respectively. Results: In 12 cases, retention cysts in 2 cases, branchial cyst in 1 case, adenoid middle fossa cyst infection in 6 cases, Tornwaldt’s cyst in 3 cases. The use of the coblation device was associated with a significant decrease in blood loss. There were no postoperative complications, and the overall follow-up period was 2-7 years and shows no signs of recurrence. Conclusions: We describe transnasal endoscopic procedures to resect cysts of the nasopharynx. We found that radiofrequency coblation is a useful and safe tool associated with minimal blood loss in the resection of these cysts. In our experience, it has been a highly successful, safe, and effective procedure. PMID:26131108

  10. Structural outcomes in the Cleft Care UK study. Part 2: dento-facial outcomes

    PubMed Central

    Al-Ghatam, R; Jones, T E M; Ireland, A J; Atack, N E; Chawla, O; Deacon, S; Albery, L; Cobb, A R M; Cadogan, J; Leary, S; Waylen, A; Wills, A K; Richard, B; Bella, H; Ness, A R; Sandy, J R

    2015-01-01

    Structured Abstract Objectives To compare facial appearance and dento-alveolar relationship outcomes from the CSAG (1998) and CCUK (2013) studies. Setting and sample population Five-year-olds born with non-syndromic unilateral cleft lip and palate. Those in the original CSAG were treated in a dispersed model of care with low-volume operators. Those in CCUK were treated in a more centralized, high-volume operator model. Materials and methods We compared facial appearance using frontal view photographs (252 CCUK, 239 CSAG) and dental relationships using study models (198 CCUK, 223 CSAG). Facial appearance was scored by a panel of six assessors using a standardized and validated outcome tool. Dento-alveolar relationships were scored by two assessors using the 5-Year-Olds’ Index. Ordinal regression was used to compare results between surveys. Results Excellent or good facial appearance was seen in 36.2% of CCUK compared with 31.9% in CSAG. In CCUK, 21.6% were rated as having poor or very poor facial appearance compared with 27.6% in CSAG. The percentage rated as having excellent or good dento-alveolar relationships was 53.0% in CCUK compared with 29.6% in CSAG. In CCUK, 19.2% were rated as having poor or very poor dento-alveolar relationships compared to 36.3% in CSAG. The odds ratios for improved outcome in CCUK compared to CSAG were 1.43 (95% CI 1.03, 1.97) for facial appearance and 2.29 (95% CI 1.47, 3.55) for dento-alveolar relationships. Conclusions Facial and dento-alveolar outcomes were better in CCUK children compared to those in CSAG. PMID:26567852

  11. The Discover artificial disc replacement versus fusion in cervical radiculopathy--a randomized controlled outcome trial with 2-year follow-up.

    PubMed

    Skeppholm, Martin; Lindgren, Lars; Henriques, Thomas; Vavruch, Ludek; Löfgren, Håkan; Olerud, Claes

    2015-06-01

    Several previous studies comparing artificial disc replacement (ADR) and fusion have been conducted with cautiously positive results in favor of ADR. This study is not, in contrast to most previous studies, an investigational device exemption study required by the Food and Drug Administration for approval to market the product in the United States. This study was partially funded with unrestricted institutional research grants by the company marketing the artificial disc used in this study. To compare outcomes between the concepts of an artificial disc to treatment with anterior cervical decompression and fusion (ACDF) and to register complications associated to the two treatments during a follow-up time of 2 years. This is a randomized controlled multicenter trial, including three spine centers in Sweden. The study included patients seeking care for cervical radiculopathy who fulfilled inclusion criteria. In total, 153 patients were included. Self-assessment with Neck Disability Index (NDI) as a primary outcome variable and EQ-5D and visual analog scale as secondary outcome variables. Patients were randomly allocated to either treatment with the Depuy Discover artificial disc or fusion with iliac crest bone graft and plating. Randomization was blinded to both patient and caregivers until time for implantation. Adverse events, complications, and revision surgery were registered as well as loss of follow-up. Data were available in 137 (91%) of the included and initially treated patients. Both groups improved significantly after surgery. NDI changed from 63.1 to 39.8 in an intention-to-treat analysis. No statistically significant difference between the ADR and the ACDF groups could be demonstrated with NDI values of 39.1 and 40.1, respectively. Nor in secondary outcome measures (EQ-5D and visual analog scale) could any statistically significant differences be demonstrated between the groups. Nine patients in the ADR group and three in the fusion group underwent

  12. Plumbing system shock absorbers as a source of Legionella pneumophila.

    PubMed

    Memish, Z A; Oxley, C; Contant, J; Garber, G E

    1992-12-01

    Water distribution systems have been demonstrated to be a major source of nosocomial legionellosis. We describe an outbreak in our institution in which a novel source of Legionella pneumophila was identified in the plumbing system. After an outbreak of 10 cases of legionellosis in our hospital, recommended measures including superheating of the hot water to 80 degrees C, hyperchlorination to 2 ppm, and flushing resulted in no new cases in the following 5 years. Recently, despite these control measures, three new cases occurred. Surveillance cultures of shower heads and water tanks were negative; cultures of tap water samples remained positive. This prompted a search for another reservoir. Shock absorbers installed within water pipes to decrease noise were suspected. One hundred twenty-five shock absorbers were removed and cultured. A total of 13 (10%) yielded heavy growth of L. pneumophila (serogroup 1). Since their removal, no new cases have been found and the percentage of positive results of random tap water culture has dropped from 20% to 5%. This is the first report that identifies shock absorbers as a possible reservoir for L. pneumophila. We recommend that institutions with endemic legionellosis assess the water system for possible removal of shock absorbers.

  13. Measurements of light-absorbing particles on the glaciers in the Cordillera Blanca, Peru

    NASA Astrophysics Data System (ADS)

    Schmitt, C. G.; All, J. D.; Schwarz, J. P.; Arnott, W. P.; Cole, R. J.; Lapham, E.; Celestian, A.

    2015-02-01

    Glaciers in the tropical Andes have been rapidly losing mass since the 1970s. In addition to the documented increase in temperature, increases in light-absorbing particles deposited on glaciers could be contributing to the observed glacier loss. Here we report on measurements of light-absorbing particles sampled from glaciers during three surveys in the Cordillera Blanca Mountains in Peru. During three research expeditions in the dry seasons (May-August) of 2011, 2012 and 2013, 240 snow samples were collected from 15 mountain peaks over altitudes ranging from 4800 to nearly 6800 m. Several mountains were sampled each of the 3 years and some mountains were sampled multiple times during the same year. Collected snow samples were melted and filtered in the field then later analyzed using the Light Absorption Heating Method (LAHM), a new technique that measures the ability of particles on filters to absorb visible light. LAHM results have been calibrated using filters with known amounts of fullerene soot, a common industrial surrogate for black carbon (BC). As sample filters often contain dust in addition to BC, results are presented in terms of effective black carbon (eBC). During the 2013 survey, snow samples were collected and kept frozen for analysis with a Single Particle Soot Photometer (SP2). Calculated eBC mass from the LAHM analysis and the SP2 refractory black carbon (rBC) results were well correlated (r2 = 0.92). These results indicate that a substantial portion of the light-absorbing particles in the more polluted regions were likely BC. The 3 years of data show that glaciers in the Cordillera Blanca Mountains close to human population centers have substantially higher levels of eBC (as high as 70 ng g-1) than remote glaciers (as low as 2.0 ng g-1 eBC), indicating that population centers can influence local glaciers by sourcing BC.

  14. A fully functionalized metamaterial perfect absorber with simple design and implementation

    PubMed Central

    Fu, Sze Ming; Zhong, Yan Kai; Tu, Ming Hsiang; Chen, Bo Ruei; Lin, Albert

    2016-01-01

    Broadband perfect metamaterial absorbers have been drawing significant attention in recent years. A close-to-unity absorption over a broad spectral range is established and this facilitates many photonic applications. A more challenging goal is to construct a broadband absorber with a tailored spectral absorption. The spectral absorption control and spectral shaping are very critical in many applications, such as thermal-photovoltaic, thermal emitters, spectrum imaging system, biomedical and extraterrestrial sensing, and refractive index sensor. In this work, one-dimensional (1D) planar stacking structure is designed to achieve the ultimate goal of a functionalized absorber with a fully tailorable spectral absorption. The lithography and etching process are totally eliminated in this proposed structure, and the fabrication is fully compatible with the regular silicon IC processing. By using ~2 nm ultra-thin metallic layers with a 10-pair (10X) SiO2/Si3N4 integrated dielectric filter, we can achieve decent spectral response shaping. The planar configuration of the ultra-thin-metal metamaterial perfect absorber (MPA) is the key to the easy design/integration of the dielectric filters on top of the MPA. Specifically, band-rejected, high-pass, low-pass and band-pass structure are constructed successfully. Finally, experimental evidence to support our simulation result is also provided, which proves the feasibility of our proposal. PMID:27782181

  15. A fully functionalized metamaterial perfect absorber with simple design and implementation.

    PubMed

    Fu, Sze Ming; Zhong, Yan Kai; Tu, Ming Hsiang; Chen, Bo Ruei; Lin, Albert

    2016-10-26

    Broadband perfect metamaterial absorbers have been drawing significant attention in recent years. A close-to-unity absorption over a broad spectral range is established and this facilitates many photonic applications. A more challenging goal is to construct a broadband absorber with a tailored spectral absorption. The spectral absorption control and spectral shaping are very critical in many applications, such as thermal-photovoltaic, thermal emitters, spectrum imaging system, biomedical and extraterrestrial sensing, and refractive index sensor. In this work, one-dimensional (1D) planar stacking structure is designed to achieve the ultimate goal of a functionalized absorber with a fully tailorable spectral absorption. The lithography and etching process are totally eliminated in this proposed structure, and the fabrication is fully compatible with the regular silicon IC processing. By using ~2 nm ultra-thin metallic layers with a 10-pair (10X) SiO 2 /Si 3 N 4 integrated dielectric filter, we can achieve decent spectral response shaping. The planar configuration of the ultra-thin-metal metamaterial perfect absorber (MPA) is the key to the easy design/integration of the dielectric filters on top of the MPA. Specifically, band-rejected, high-pass, low-pass and band-pass structure are constructed successfully. Finally, experimental evidence to support our simulation result is also provided, which proves the feasibility of our proposal.

  16. Low temperature selective absorber research

    NASA Astrophysics Data System (ADS)

    Herzenberg, S. A.; Silberglitt, R.

    1982-04-01

    Research carried out since 1979 on selective absorbers is surveyed, with particular attention given to the low-temperature coatings seen as promising for flat plate and evacuated tube applications. The most thoroughly investigated absorber is black chrome, which is highly selective and is the most durable low-temperature absorber. It is believed that other materials, because of their low cost and lower content of strategic materials, may eventually supplant black chrome. Among these candidates are chemically converted black nickel; anodically oxidized nickel, zinc, and copper composites; and nickel or other low-cost multilayer coatings. In reviewing medium and high-temperature research, black chrome, multilayer coatings and black cobalt are seen as best medium-temperature candidates. For high temperatures, an Al2O3/Pt-Al203 multilayer composite or the zirconium diboride coating is preferred.

  17. Speech concerns at 5 years and adult educational and mental health outcomes.

    PubMed

    Muir, Colette; O'Callaghan, Michael J; Bor, William; Najman, Jake M; Williams, Gail M

    2011-07-01

    To determine if parent-reported speech concerns at 5 years predict poorer educational and mental health outcomes at 21 years independent of social context and child's receptive language, behaviour and motor concerns at 5 years. To determine if these adult outcomes are mediated by school performance at 14 years.   Information on speech concerns at 5- and 21-year outcomes was available for 3193 participants from a birth cohort of 7223 infants. At 5, child behaviour was measured using a behavioural checklist, and at 21 years, it was measured by the Young Adult Self-Report. Peabody Picture Vocabulary Test-Revised at 5 years was not available for all children. Maternal mental health and social information at 5 years and educational outcomes at 14 years and 21 years were collected prospectively by questionnaire. Potential confounding and mediating factors were analysed using logistic regression. Children with speech concerns were less likely to have completed secondary school (P < 0.01) or gained better overall position (OP) scores (P < 0.001). OP scores rank students in Queensland applying for tertiary entrance. There was no association with mental health outcomes. Findings were independent of maternal and social factors, and motor concerns, though attenuated by behaviour and Peabody Picture Vocabulary Test-Revised scores. In the model adjusted for these factors, any concerns predicted OP score 1-11 (odds ratio 0.58; 95% confidence interval 0.42, 0.79), though if academic functioning at 14 was included, no associations were significant. Maternal-reported speech concerns at 5 years predict poorer educational though not adult mental health outcomes. © 2011 The Authors. Journal of Paediatrics and Child Health © 2011 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  18. Limitations of Cs3Bi2I9 as lead-free photovoltaic absorber materials.

    PubMed

    Ghosh, Biplab; Wu, Bo; Mulmudi, Hemant Kumar; Guet, Claude; Weber, Klaus; Sum, Tze Chien; Mhaisalkar, Subodh G; Mathews, Nripan

    2018-01-17

    Lead (Pb) halide perovskites have attracted tremendous attention in recent years due to their rich optoelectronic properties, which have resulted in more than 22% power conversion efficient photovoltaics. Nevertheless, Pb-metal toxicity remains a huge hurdle for extensive applications of these compounds. Thus, alternative compounds with similar optoelectronic properties need to be developed. Bismuth possesses similar electronic structure as that of lead with the presence of ns2 electrons that exhibit rich structural variety as well as interesting optical and electronic properties. Herein, we critically assess Cs3Bi2I9 as a candidate for thin-film solar cell absorber. Despite a reasonable optical bandgap (~2eV) and absorption coefficient, the power conversion efficiency of the Cs3Bi2I9 mesoscopic solar cells was found to be severely lacking, limited by poor photocurrent density. The efficiency of the Cs3Bi2I9 solar cell can be slightly improved by changing the stoichiometry of the precursor solutions. We have investigated the possible reasons behind the poor performance of Cs3Bi2I9 by transient absorption and luminescence spectroscopy. Comparison between thin-films and single crystals highlights the presence of intrinsic defects in thin-films which act as nonradiative recombination centers.

  19. One-year outcomes of AquaLase cataract surgery.

    PubMed

    Yoo, Sonia H; Bhatt, Anand B

    2007-01-01

    The authors report surgical experience and clinical outcomes up to 1 year postoperatively in patients who underwent cataract surgery with the AquaLase liquefaction device (Alcon Laboratories, Fort Worth, TX). The device is a handpiece option for use with Alcon's Infiniti Vision System that uses heated balanced saline solution micropulses to liquefy lenticular material. Twenty-seven eyes of 23 patients underwent cataract extraction with the use of the AquaLase liquefaction device. The average age of participants was 68 years, and the average nuclear sclerotic grade was 1.96 on a 4-point scale. Outcomes were judged by metrics such as visual acuity, inflammation, endothelial cell count, and postoperative posterior capsule opacification. At 30 days postoperatively, 78% of eyes had a best-corrected visual acuity of 20/20. Visual acuity was 20/25 or better 1 year postoperatively in 88% of patients without complications except conversion to ultrasound phacoemulsification for two dense cataracts.

  20. Incidence and Functional Outcomes of Scapholunate Diastases Associated Distal Radius Fractures: A 2-year Follow-Up Scapholunate Dissociation.

    PubMed

    Lans, Jonathan; Lasa, Alejandro; Chen, Neal C; Jupiter, Jesse B

    2018-01-01

    The Scapholunate Interosseous Ligament (SLIL) is the first intrinsic carpal ligament to be injured in wrist trauma, present in up to 64% of the distal radius fractures. However, it remains unclear what patients develop symptoms, making primary treatment of these injuries accompanying distal radius fractures remains questionable. The aim of this study was to evaluate the functional outcomes of patients with scapholunate diastasis associated with distal radius fractures. We evaluated 391 patients with a distal radius fracture. Using Computer Tomography (CT) scans the scapholunate interval was measured. We identified 14 patients with an SLD (>3mm) of the injured wrist, which underwent a CT-scan of the contralateral wrist. To evaluate the functional outcomes at a mean follow up of 136±90 weeks, we used the Quick Disabilities of the Arm, Shoulder and Hand (qDASH) Score. There were 8 patients with bilateral SLD and 6 patients with unilateral SLD. Five patients had a qDASH score of 0 and one patient showed a qDASH score of 18.2. The patient with a poor score had bilateral preexisting osteoarthritis of the wrist. No patient had additional surgery of the SLIL. In patients with distal radius fractures, more than half of the 14 patients with an SL gap on CT had widening on the contralateral side. It is therefore worthwhile to image the contralateral wrist before diagnosing a SLD. The patients with unilateral SLD should not be surgically treated at initial presentation because they may have good functional outcomes after a follow up of 2 years.

  1. Shock-absorbing and failure mechanisms of WS2 and MoS2 nanoparticles with fullerene-like structures under shock wave pressure.

    PubMed

    Zhu, Yan Qiu; Sekine, Toshimori; Li, Yan Hui; Fay, Michael W; Zhao, Yi Min; Patrick Poa, C H; Wang, Wen Xin; Roe, Martin J; Brown, Paul D; Fleischer, Niles; Tenne, Reshef

    2005-11-23

    The excellent shock-absorbing performance of WS2 and MoS2 nanoparticles with inorganic fullerene-like structures (IFs) under very high shock wave pressures of 25 GPa is described. The combined techniques of X-ray diffraction, Raman spectroscopy, X-ray photoelectron spectroscopy, thermal analysis, and transmission electron microscopy have been used to evaluate the diverse, intriguing features of shock recovered IFs, of interest for their tribological applications, thereby allowing improved understanding of their antishock behavior and structure-property relationships. Two possible failure mechanisms are proposed and discussed. The supershock-absorbing ability of the IF-WS2 enables them to survive pressures up to 25 GPa accompanied with concurrent temperatures of up to 1000 degrees C without any significant structural degradation or phase change making them probably the strongest cage molecules now known.

  2. Three-Year Outcomes of Bariatric Surgery vs Lifestyle Intervention for Type 2 Diabetes Mellitus Treatment: A Randomized Clinical Trial.

    PubMed

    Courcoulas, Anita P; Belle, Steven H; Neiberg, Rebecca H; Pierson, Sheila K; Eagleton, Jessie K; Kalarchian, Melissa A; DeLany, James P; Lang, Wei; Jakicic, John M

    2015-10-01

    Questions remain about the role and durability of bariatric surgery for type 2 diabetes mellitus (T2DM). To compare the remission of T2DM following surgical and nonsurgical treatments. In this 3-arm randomized clinical trial conducted at the University of Pittsburgh Medical Center from October 1, 2009, to June 26, 2014, in Pittsburgh, Pennsylvania, outcomes were assessed 3 years after treating 61 obese participants aged 25 to 55 years with T2DM. Analysis was conducted with an intent-to-treat population. Participants were randomized to either an intensive lifestyle weight loss intervention for 1 year followed by a low-level lifestyle intervention for 2 years or surgical treatments (Roux-en-Y gastric bypass [RYGB] or laparoscopic adjustable gastric banding [LAGB]) followed by low-level lifestyle intervention in years 2 and 3. Primary end points were partial and complete T2DM remission and secondary end points included diabetes medications and weight change. Body mass index (calculated as weight in kilograms divided by height in meters squared) was less than 35 for 26 participants (43%), 50 (82%) were women, and 13 (21%) were African American. Mean (SD) values were 100.5 (13.7) kg for weight, 47.3 (6.6) years for age, 7.8% (1.9%) for hemoglobin A1c level, and 171.3 (72.5) mg/dL for fasting plasma glucose level. Partial or complete T2DM remission was achieved by 40% (n = 8) of RYGB, 29% (n = 6) of LAGB, and no intensive lifestyle weight loss intervention participants (P = .004). The use of diabetes medications was reduced more in the surgical groups than the lifestyle intervention-alone group, with 65% of RYGB, 33% of LAGB, and none of the intensive lifestyle weight loss intervention participants going from using insulin or oral medication at baseline to no medication at year 3 (P < .001). Mean (SE) reductions in percentage of body weight at 3 years were the greatest after RYGB at 25.0% (2.0%), followed by LAGB at 15.0% (2.0%) and lifestyle treatment at

  3. Outcomes of childhood asthma to the age of 50 years.

    PubMed

    Tai, Andrew; Tran, Haily; Roberts, Mary; Clarke, Nadeene; Gibson, Anne-Marie; Vidmar, Suzanna; Wilson, John; Robertson, Colin F

    2014-06-01

    In 1964, The Melbourne Asthma Study was established to describe the spectrum and natural history of childhood asthma. To describe the clinical and lung function outcome of childhood asthma to the age of 50 years. Subjects were invited to complete an interviewer-administered questionnaire, skin prick testing, and measurement of lung function from the age of 7 years to the age of 50 years at 7-year intervals. Of 458 survivors (from the original 484 subjects at recruitment), 346 subjects (76%) participated, of whom, 197 completed lung function measurement. Asthma remission at the age of 50 years was 64% in those with wheezy bronchitis, 47% for those with persistent asthma, and 15% for those with severe asthma in childhood. Multivariable analysis identified severe asthma in childhood (odds ratio [OR] 11.9 [95% CI, 3.4-41.8]), female sex (OR 2.0 [95% CI, 1.1-3.6]), and childhood hay fever (OR 2.0 [95% CI, 1.0-4.0]) as risk factors for "current asthma" at age 50 years. There was no evidence of a difference in the rate of decline in FEV1 (mL/y, 95% CI) between the severe asthma group (15 mL/y [95% CI, 9-22 mL/y]) and all the other recruitment groups: control (16 mL/y [95% CI, 12-20 mL/y]), mild wheezy bronchitis (14 mL/y [95% CI, 8-19 mL/y]), wheezy bronchitis (16 mL/y [95% CI, 11-20 mL/y]), and persistent asthma (19 mL/y [95% CI, 13-24 mL/y]). The clinical and lung function outcome in adult life is strongly determined by asthma severity in childhood. The reduced lung function seen in adults is established in childhood and does not appear to decline more rapidly in adult years despite continuing symptoms. Copyright © 2014 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.

  4. Aspheric photorefractive keratectomy for myopia and myopic astigmatism with the SCHWIND AMARIS laser: 2 years postoperative outcomes

    PubMed Central

    Aslanides, Ioannis M.; Padroni, Sara; Arba-Mosquera, Samuel

    2012-01-01

    Purpose To evaluate mid-term refractive outcomes and higher order aberrations of aspheric PRK for low, moderate and high myopia and myopic astigmatism with the AMARIS excimer laser system (SCHWIND eye-tech-solutions GmbH, Kleinostheim, Germany). Methods This prospective longitudinal study evaluated 80 eyes of 40 subjects who underwent aspheric PRK. Manifest refractive spherical equivalent (MRSE) of up to −10.00 diopters (D) at the spectacle plane with cylinder up to 3.25 was treated. Refractive outcomes and corneal wavefront data (6 mm pupil to the 7th Zernike order) were evaluated out to 2 years postoperatively. Statistical significance was indicated by P < 0.05. Results The mean manifest spherical equivalent refraction (MRSE) was −4.77 ± 2.45 (range, −10.00 D to −0.75 D) preoperatively and −0.12 ± 0.35 D (range, −1.87 D to +0.75 D) postoperatively (P < 0.0001). Postoperatively, 91% (73/80) of eyes had an MRSE within ±0.50 D of the attempted. No eyes lost one or more lines of corrected distance visual acuity (CDVA) and CDVA increased by one or more lines in 26% (21/80) of eyes. Corneal trefoil and corneal higher order aberration root mean square did not statistically change postoperatively compared to preoperatively (P > 0.05, both cases). There was a statistical increase in postoperative coma (+0.12 μm) and spherical aberration (+0.14 μm) compared to preoperatively (P < 0.001, both cases). Conclusion Aspheric PRK provides excellent visual and refractive outcomes with induction in individual corneal aberrations but not overall corneal aberrations.

  5. Keck and VLT Observations of Super-Damped Lyman-Alpha Absorbers at z 2- 2.5: Constraints on Chemical Compositions and Physical Conditions

    NASA Astrophysics Data System (ADS)

    Kulkarni, Varsha P.; Som, Debopam; Morrison, Sean; Péroux, Celine; Quiret, Samuel; York, Donald G.

    2015-12-01

    We report Keck/Echellette Spectrograph and Imager and Very Large Telescope/Ultraviolet-Visual Echelle Spectrograph observations of three super-damped Lyα quasar absorbers with H i column densities log NH i ≥ 21.7 at redshifts 2 ≲ z ≲ 2.5. All three absorbers show similar metallicities (˜-1.3 to -1.5 dex), and dust depletion of Fe, Ni, and Mn. Two of the absorbers show supersolar [S/Zn] and [Si/Zn]. We combine our results with those for other damped Lyα a absorbers (DLAs) to examine trends between NH i, metallicity, and dust depletion. A larger fraction of the super-DLAs lie close to or above the line [X/H] = 20.59 - log NH i in the metallicity versus NH i plot, compared to the less gas-rich DLAs, suggesting that super-DLAs are more likely to be rich in molecules. Unfortunately, our data for Q0230-0334 and Q0743+1421 do not cover H2 absorption lines. For Q1418+0718, some H2 lines are covered, but not detected. CO is not detected in any of our absorbers. For DLAs with log NH i < 21.7, we confirm strong correlation between metallicity and Fe depletion, and find a correlation between metallicity and Si depletion. For super-DLAs, these correlations are weaker or absent. The absorbers toward Q0230-0334 and Q1418+0718 show potential detections of weak Lyα emission, implying star formation rates of ˜1.6 and ˜0.7 M⊙ yr-1, respectively (ignoring dust extinction). Upper limits on the electron densities from C ii*/C ii or Si ii*/Si ii are low, but are higher than the median values in less gas-rich DLAs. Finally, systems with log NH i > 21.7 may have somewhat narrower velocity dispersions Δv90 than the less gas-rich DLAs, and may arise in cooler and/or less turbulent gas. Includes observations collected during program ESO 93.A-0422 at the European Southern Observatory (ESO) Very Large Telescope (VLT) with the Ultraviolet-Visual Echelle Spectrograph (UVES) on the 8.2 m telescopes operated at the Paranal Observatory, Chile. Some of the data presented herein were

  6. Investigation into the energy-absorbing properties of multilayered circular thin-walled tube

    NASA Astrophysics Data System (ADS)

    Qi, Aidong; Liu, Chuanhua; Hu, Gongli; Gu, Hongjun

    2002-05-01

    With the rise in collision accident and the increase in requirement for resistance of blastproof structures in recent years, people attach much importance to the research and application of energy-absorbing device. In this paper the author calculates the specific strength, the specific hardness and ultimate internal force of a circular thin-walled tube by theoretic calculations, discusses the feasibility of using circular thin-walled tube as an energy-absorbing element, analyzes the energy-absorbing properties and the energy-absorbing mechanism through the energy-absorbing experiments using various materials and forms of arrangement, reaches the conclusion that the load-bearing capacity and energy-absorbing properties of multilayered tubes are superior to that of single tube, and puts forward the concept of 'grading tube'.

  7. Internal absorber solar collector

    DOEpatents

    Sletten, Carlyle J.; Herskovitz, Sheldon B.; Holt, F. S.; Sletten, E. J.

    1981-01-01

    Thin solar collecting panels are described made from arrays of small rod collectors consisting of a refracting dielectric rod lens with an absorber imbedded within it and a reflecting mirror coated on the back side of the dielectric rod. Non-tracking collector panels on vertical walls or roof tops receive approximately 90% of solar radiation within an acceptance zone 60.degree. in elevation angle by 120.degree. or more in the azimuth sectors with a collector concentration ratio of approximately 3.0. Miniaturized construction of the circular dielectric rods with internal absorbers reduces the weight per area of glass, plastic and metal used in the collector panels. No external parts or insulation are needed as heat losses are low due to partial vacuum or low conductivity gas surrounding heated portions of the collector. The miniature internal absorbers are generally made of solid copper with black selective surface and the collected solar heat is extracted at the collector ends by thermal conductivity along the absorber rods. Heat is removed from end fittings by use of liquid circulants. Several alternate constructions are provided for simplifying collector panel fabrication and for preventing the thermal expansion and contraction of the heated absorber or circulant tubes from damaging vacuum seals. In a modified version of the internal absorber collector, oil with temperature dependent viscosity is pumped through a segmented absorber which is now composed of closely spaced insulated metal tubes. In this way the circulant is automatically diverted through heated portions of the absorber giving higher collector concentration ratios than theoretically possible for an unsegmented absorber.

  8. Improving Phytoremediation of Oil Spills through Organic Absorbents

    NASA Astrophysics Data System (ADS)

    Xie, W.

    2017-12-01

    Every year, oil spills around the world contaminate the environment and cost billions of dollars to clean up. Phytoremediation is a current technology for recovering environments contaminated by harmful substances, such as oil, that utilizes plants' capabilities to concentrate and metabolize the contaminants. Ranunculus, or the buttercup, has raised interest in the field of phytoremediation, being reported to grow in waste environments including municipal waste disposals. My project confirmed Ranunculus to be a suitable plant for phytoremediation. However, the Ranunculus plants throughout experiments showed a limited tolerance for oil concentration, causing the plant to wilt, thus ending the phytoremediation process. To overcome this problem, my project explored the combination of organic oil absorbents and phytoremediation. Oil absorbents can quickly fix the spilled oil in place and prevent it from further migration. In addition, and most importantly, the initial free oil concentration in contact with the roots is thus effectively decreased, which is essential for the plants to survive. Typha(cattail) inflorescence, saw dust, cotton and a commercial polymer were tested for oil absorption and Typha was deemed superior, being highly oil absorbent, inexpensive, organic and hydrophobic. Further experiments were undertaken in a small outdoor space and in the UBC Horticulture greenhouse during the winter season over the course of one year. The experiments were set up to both determine the most suitable plant for phytoremediation and test the impact of using Typha inflorescence as an absorbent. For each plant, there were three pots with Typha inflorescence and oil, with oil but no Typha inflorescence and without either. In order to measure the benefit quantitatively, naturally occurring electrical currents of the metabolic process common in phytoremediation was used as an indicator for phytoremediative activity. The main findings of the experiments were: 1. Adding Typha

  9. Vibration analysis on compact car shock absorber

    NASA Astrophysics Data System (ADS)

    Tan, W. H.; Cheah, J. X.; Lam, C. K.; Lim, E. A.; Chuah, H. G.; Khor, C. Y.

    2017-10-01

    Shock absorber is a part of the suspension system which provides comfort experience while driving. Resonance, a phenomenon where forced frequency is coinciding with the natural frequency has significant effect on the shock absorber itself. Thus, in this study, natural frequencies of the shock absorber in a 2 degree-of-freedom system were investigated using Wolfram Mathematica 11, CATIA, and ANSYS. Both theoretical and simulation study how will the resonance affect the car shock absorber. The parametric study on the performance of shock absorber also had been conducted. It is found that the failure tends to occur on coil sprung of the shock absorber before the body of the shock absorber is fail. From mathematical modelling, it can also be seen that higher vibration level occurred on un-sprung mass compare to spring mass. This is due to the weight of sprung mass which could stabilize as compared with the weight of un-sprung mass. Besides that, two natural frequencies had been obtained which are 1.0 Hz and 9.1 Hz for sprung mass and un-sprung mass respectively where the acceleration is recorded as maximum. In conclusion, ANSYS can be used to validate with theoretical results with complete model in order to match with mathematical modelling.

  10. Three-year Treatment Outcomes in the Ahmed Baerveldt Comparison Study

    PubMed Central

    Barton, Keith; Feuer, William J; Budenz, Donald L; Schiffman, Joyce; Costa, Vital P.; Godfrey, David G.; Buys, Yvonne M.

    2014-01-01

    Purpose To compare three year outcomes and complications of the Ahmed FP7 Glaucoma Valve (AGV) and Baerveldt 101–350 Glaucoma Implant (BGI) for the treatment of refractory glaucoma. Design Multicenter randomized controlled clinical trial. Participants 276 patients; 143 in the AGV group and 133 in the BGI group. Methods Patients aged 18–85 years with refractory glaucoma and intraocular pressures (IOPs) ≥18 mmHg in whom an aqueous shunt was planned were randomized to either an AGV or a BGI. Main Outcome Measures IOP, visual acuity, supplemental medical therapy, complications, and failure (IOP > 21 mmHg or not reduced by 20% from baseline, IOP ≤ 5 mmHg, reoperation for glaucoma or removal of implant, or loss of light perception vision). Results At 3 years, IOP (mean ± standard deviation) (SD) was 14.3 ± 4.7 mmHg (AGV group) and 13.1 ± 4.5 mmHg (BGI group) (p = 0.086) on 2.0 ± 1.4 and 1.5 ± 1.4 glaucoma medications respectively (p = 0.020). The cumulative probabilities of failure were 31.3% (standard error = 4.0%) (SE) (AGV) and 32.3% (4.2%) (BGI) (p = 0.99). Postoperative complications associated with reoperation or vision loss of ≥ 2 Snellen lines occurred in 24 patients (22%) (AGV) and 38 patients (36%) (BGI) (p = 0.035). The mean change in the Logarithm of the Minimum Angle of Resolution visual acuity (logMAR VA) at 3 years was similar (AGV: 0.21 ± 0.88, BGI: 0.26 ± 0.74) in the two treatment groups at 3 years (p=0.66). The cumulative proportion of patients (SE) undergoing reoperation for glaucoma prior to the three year postoperative time point was 14.5% (3.0%) in the AGV group compared to 7.6% (2.4%) in the BGI group (p=0.053, log-rank). The relative risk of reoperation for glaucoma in the AGV group was 2.1 times that of the BGI group (95% Confidence Interval:1.0–4.8, p=0.045; Cox proportional hazards regression). Conclusions AGV implantation was associated with the need for significantly greater adjunctive medication to achieve equal success

  11. Brain MRI Characteristics of Patients with Anti-N-Methyl-D-Aspartate Receptor Encephalitis and Their Associations with 2-Year Clinical Outcome.

    PubMed

    Zhang, T; Duan, Y; Ye, J; Xu, W; Shu, N; Wang, C; Li, K; Liu, Y

    2018-05-01

    Anti- N -methyl-D-aspertate receptor encephalitis is an autoimmune-mediated disease without specific brain MRI features. Our aim was to investigate the brain MR imaging characteristics of anti- N -methyl-D-aspartate receptor encephalitis and their associations with clinical outcome at a 2-year follow-up. We enrolled 53 patients with anti- N -methyl-D-aspartate receptor encephalitis and performed 2-year follow-up. Brain MRIs were acquired for all patients at the onset phase. The brain MR imaging manifestations were classified into 4 types: type 1: normal MR imaging findings; type 2: only hippocampal lesions; type 3: lesions not involving the hippocampus; and type 4: lesions in both the hippocampus and other brain areas. The modified Rankin Scale score at 2-year follow-up was assessed, and the association between the mRS and onset brain MR imaging characteristics was evaluated. Twenty-eight (28/53, 53%) patients had normal MR imaging findings (type 1), and the others (25/53, 47%) had abnormal MRI findings: type 2: 7 patients (13%); type 3: seven patients (13%); and type 4: eleven patients (21%). Normal brain MRI findings were more common in female patients ( P = .02). Psychiatric and behavioral abnormalities were more common in adults ( P = .015), and autonomic symptoms ( P = .025) were more common in pediatric patients. The presence of hippocampal lesions ( P = .008, OR = 9.584; 95% CI, 1.803-50.931) and relapse ( P = .043, OR = 0.111; 95% CI, 0.013-0.930) was associated with poor outcome. Normal brain MRI findings were observed in half of the patients. Lesions in the hippocampus were the most common MR imaging abnormal finding. The presence of hippocampal lesions is the main MR imaging predictor for poor prognosis in patients with anti- N -methyl-D-aspartate receptor encephalitis. © 2018 by American Journal of Neuroradiology.

  12. Design of a nonlinear torsional vibration absorber

    NASA Astrophysics Data System (ADS)

    Tahir, Ammaar Bin

    Tuned mass dampers (TMD) utilizing linear spring mechanisms to mitigate destructive vibrations are commonly used in practice. A TMD is usually tuned for a specific resonant frequency or an operating frequency of a system. Recently, nonlinear vibration absorbers attracted attention of researchers due to some potential advantages they possess over the TMDs. The nonlinear vibration absorber, or the nonlinear energy sink (NES), has an advantage of being effective over a broad range of excitation frequencies, which makes it more suitable for systems with several resonant frequencies, or for a system with varying excitation frequency. Vibration dissipation mechanism in an NES is passive and ensures that there is no energy backflow to the primary system. In this study, an experimental setup of a rotational system has been designed for validation of the concept of nonlinear torsional vibration absorber with geometrically induced cubic stiffness nonlinearity. Dimensions of the primary system have been optimized so as to get the first natural frequency of the system to be fairly low. This was done in order to excite the dynamic system for torsional vibration response by the available motor. Experiments have been performed to obtain the modal parameters of the system. Based on the obtained modal parameters, the design optimization of the nonlinear torsional vibration absorber was carried out using an equivalent 2-DOF modal model. The optimality criterion was chosen to be maximization of energy dissipation in the nonlinear absorber attached to the equivalent 2-DOF system. The optimized design parameters of the nonlinear absorber were tested on the original 5-DOF system numerically. A comparison was made between the performance of linear and nonlinear absorbers using the numerical models. The comparison showed the superiority of the nonlinear absorber over its linear counterpart for the given set of primary system parameters as the vibration energy dissipation in the former is

  13. Absorber for terahertz radiation management

    DOEpatents

    Biallas, George Herman; Apeldoorn, Cornelis; Williams, Gwyn P.; Benson, Stephen V.; Shinn, Michelle D.; Heckman, John D.

    2015-12-08

    A method and apparatus for minimizing the degradation of power in a free electron laser (FEL) generating terahertz (THz) radiation. The method includes inserting an absorber ring in the FEL beam path for absorbing any irregular THz radiation and thus minimizes the degradation of downstream optics and the resulting degradation of the FEL output power. The absorber ring includes an upstream side, a downstream side, and a plurality of wedges spaced radially around the absorber ring. The wedges form a scallop-like feature on the innermost edges of the absorber ring that acts as an apodizer, stopping diffractive focusing of the THz radiation that is not intercepted by the absorber. Spacing between the scallop-like features and the shape of the features approximates the Bartlett apodization function. The absorber ring provides a smooth intensity distribution, rather than one that is peaked on-center, thereby eliminating minor distortion downstream of the absorber.

  14. EEG abnormalities and two year outcome in first episode psychosis.

    PubMed

    Manchanda, R; Norman, R; Malla, A; Harricharan, R; Takhar, J; Northcott, S

    2005-03-01

    This study examines the relationship of EEG to 2 year symptomatic outcome, duration of illness and untreated psychosis and gender. A total of 122 patients presenting for treatment of first episode psychosis had their baseline EEG classified by modified Mayo Clinic system criteria as normal, essentially normal or dysrhythmia. Positive and negative symptoms of psychoses were rated on entry and after 2 years of treatment. The socio-demographic variables and duration of illness and of untreated psychosis were also recorded. Patients with a normal EEG showed significantly more reduction in both positive and negative symptoms of psychoses over 2 years and were more likely to be in 'remission' as compared with the essentially normal or dysrhythmia group. The dysrhythmic group had significantly higher duration of illness than either the normal or essentially normal groups. There were no gender differences in the distribution of EEGs. An abnormal EEG in patients with first episode psychosis is associated with a poorer prognosis and a longer duration of untreated illness. Copyright (c) Blackwell Munksgaard 2005

  15. Method of absorbing UF.sub.6 from gaseous mixtures in alkamine absorbents

    DOEpatents

    Lafferty, Robert H.; Smiley, Seymour H.; Radimer, Kenneth J.

    1976-04-06

    A method of recovering uranium hexafluoride from gaseous mixtures employing as an absorbent a liquid composition at least one of the components of which is chosen from the group consisting of ethanolamine, diethanolamine, and 3-methyl-3-amino-propane-diol-1,2.

  16. Long term measurements of light absorbing particles on tropical glaciers

    NASA Astrophysics Data System (ADS)

    Schmitt, C. G.; Sanchez Rodriguez, W.; Arnott, W. P.; All, J.; Schwarz, J. P.

    2016-12-01

    We present results of six years of measurements of light absorbing particles (LAP) on glaciers of the Cordillera Blanca mountain range in Peru. Tropical glaciers are important sources of water for human consumption, agriculture, and hydroelectric power in the region. Regular measurements in the dry season show that light absorbing particle concentrations are generally low (equivalent to the absorption equivalent of 5-30 nanograms of black carbon per gram of snow) during non-El Nino years while values increase substantially during the recent El Nino. Two years of monthly measurements at two glaciers show that fresh snow LAP concentration are very low while LAP levels increase dramatically during snow-less periods.

  17. Spectral estimators of absorbed photosynthetically active radiation in corn canopies

    NASA Technical Reports Server (NTRS)

    Gallo, K. P.; Daughtry, C. S. T.; Bauer, M. E.

    1985-01-01

    Most models of crop growth and yield require an estimate of canopy leaf area index (LAI) or absorption of radiation. Relationships between photosynthetically active radiation (PAR) absorbed by corn canopies and the spectral reflectance of the canopies were investigated. Reflectance factor data were acquired with a Landsat MSS band radiometer. From planting to silking, the three spectrally predicted vegetation indices examined were associated with more than 95 percent of the variability in absorbed PAR. The relationships developed between absorbed PAR and the three indices were evaluated with reflectance factor data acquired from corn canopies planted in 1979 through 1982. Seasonal cumulations of measured LAI and each of the three indices were associated with greater than 50 percent of the variation in final grain yields from the test years. Seasonal cumulations of daily absorbed PAR were associated with up to 73 percent of the variation in final grain yields. Absorbed PAR, cumulated through the growing season, is a better indicator of yield than cumulated leaf area index. Absorbed PAR may be estimated reliably from spectral reflectance data of crop canopies.

  18. Spectral estimators of absorbed photosynthetically active radiation in corn canopies

    NASA Technical Reports Server (NTRS)

    Gallo, K. P.; Daughtry, C. S. T.; Bauer, M. E.

    1984-01-01

    Most models of crop growth and yield require an estimate of canopy leaf area index (LAI) or absorption of radiation. Relationships between photosynthetically active radiation (PAR) absorbed by corn canopies and the spectral reflectance of the canopies were investigated. Reflectance factor data were acquired with a LANDSAT MSS band radiometer. From planting to silking, the three spectrally predicted vegetation indices examined were associated with more than 95% of the variability in absorbed PAR. The relationships developed between absorbed PAR and the three indices were evaluated with reflectance factor data acquired from corn canopies planted in 1979 through 1982. Seasonal cumulations of measured LAI and each of the three indices were associated with greater than 50% of the variation in final grain yields from the test years. Seasonal cumulations of daily absorbed PAR were associated with up to 73% of the variation in final grain yields. Absorbed PAR, cumulated through the growing season, is a better indicator of yield than cumulated leaf area index. Absorbed PAR may be estimated reliably from spectral reflectance data of crop canopies.

  19. Absorber Materials for Transition-Edge Sensor X-ray Microcalorimeters

    NASA Technical Reports Server (NTRS)

    Brown, Ari-David; Bandler, Simon; Brekosky, Regis; Chervenak, James; Figueroa-Feliciano, Enectali; Finkbeiner, Fred; Sadleir, Jack; Iyomoto, Naoko; Kelley, Richard; Kilbourne, Caroline; hide

    2007-01-01

    Arrays of superconducting transition-edge sensors (TES) can provide high spatial and energy resolution necessary for x-ray astronomy. High quantum efficiency and uniformity of response can be achieved with a suitable absorber material, in which absorber x-ray stopping power, heat capacity, and thermal conductivity are relevant parameters. Here we compare these parameters for bismuth and gold. We have fabricated electroplated gold, electroplated gold/electroplated bismuth, and evaporated gold/evaporated bismuth 8x8 absorber arrays and find that a correlation exists between the residual resistance ratio (RRR) and thin film microstructure. This finding indicates that we can tailor absorber material conductivity via microstructure alteration, so as to permit absorber thermalization on timescales suitable for high energy resolution x-ray microcalorimetry. We show that by incorporating absorbers possessing large grain size, including electroplated gold and electroplated gold/electroplated bismuth, into our current Mo/Au TES, devices with tunable heat capacity and energy resolution of 2.3 eV (gold) and 2.1 eV (gold/bismuth) FWHM at 6 keV have been fabricated.

  20. Fourteen-year outcomes of abdominal aortic endovascular repair with the Zenith stent graft.

    PubMed

    Verzini, Fabio; Romano, Lydia; Parlani, Gianbattista; Isernia, Giacomo; Simonte, Gioele; Loschi, Diletta; Lenti, Massimo; Cao, Piergiorgio

    2017-02-01

    Long-term results of abdominal aortic aneurysm (AAA) endovascular repair are affected by graft design renewals that tend to improve the performance of older generation prostheses but usually reset the follow-up times to zero. The present study investigated the long-term outcomes of endovascular AAA repair (EVAR) using the Zenith graft, still in use without major modification, in a single center experience. Between 2000 and 2011, 610 patients underwent elective EVAR using the Zenith endograft (Cook Inc, Bloomington, Ind) and represent the study group. Primary outcomes were overall survival, freedom from AAA rupture, and freedom from AAA-related death. Secondary outcomes included freedom from late (>30 days) reintervention, freedom from late (>30 days) conversion to open repair, freedom from aneurysm sac enlargement >5.0 mm and freedom from EVAR failure, defined as a composite of AAA-related death, AAA rupture, AAA growth >5 mm, and any reintervention. Mean age was 73.2 years. Mean aneurysm diameter was 55.3 mm. There were five perioperative deaths (0.8%) and three intraoperative conversions. At a mean follow-up of 99.2 (range, 0-175) months, seven AAA ruptures occurred, all fatal except one. Overall survival was 92.8% ± 1.1% at 1 year, 70.1% ± 1.9% at 5 years, 37.8% ± 2.9% at 10 years, and 24 ± 4% at 14 years. Freedom from AAA-rupture was 99.8% ± 0.02 at 1 year (one case), 99.4% ± 0.04 at 5 years (three cases), and 98.1% ± 0.07 at 10 and 14 years. Freedom from late reintervention and conversion was 98% ± 0.6 at 1 year, 87.7% ± 1.5 at 5 years, 75.7% ± 3.2 at 10 years, and 69.9% ± 5.2 at 14 years. Freedom from aneurysm sac growth >5.0 mm was 99.8% at 1 year, 96.6% ± 0.7 at 5 years, 81.0% ± 3.4 at 10 years, and 74.1% ± 5.8% at 14 years. EVAR failure occurred in 132 (21.6%) patients at 14 years. At multivariate analysis, independent predictors of EVAR failure resulted type I and III endoleak (hazard ratio [HR], 6.7; 95

  1. Wave Absorber with Fine Weatherability for Improving ETC Environment

    NASA Astrophysics Data System (ADS)

    Miura, Yu; Matsumoto, Kouta; Okada, Osamu; Hashimoto, Osamu

    Wave absorber of rubber sheet containing natural rubber and EPDM is designed, fabricated and measured for improving ETC environment. As a result, proposed absorption material has fine weatherability and wave absorption satisfied with ETC standard can be realized theoretically before and after the weatherability test if the thickness of absorber is fabricated at the ranging from 2.26mm to 2.52mm. Moreover, absorber sheet sample based on theoretical values is fabricated and are measured. As a result, 20dB or more is also confirmed at the incident angle ranging from 5 to 55 degrees experimentally. Therefore, the wave absorber with fine weatherability being satisfied with ETC standard can be realized.

  2. Project LIFT: Year Three Student Outcomes Memo

    ERIC Educational Resources Information Center

    Norton, Michael; Kim, Dae Y.; Long, Daniel A.

    2016-01-01

    Research for Action (RFA) was commissioned to evaluate changes in student outcomes during the first three years of the Project Leadership and Investment for Transformation (LIFT). This report focuses on two questions: (1) how do LIFT students' behavioral and academic performance compare to those of a matched set of non-LIFT comparison students?;…

  3. Sex and Racial/Ethnic Differences in Positive Outcomes in Delinquent Youth After Detention: A 12-Year Longitudinal Study.

    PubMed

    Abram, Karen M; Azores-Gococo, Nicole M; Emanuel, Kristin M; Aaby, David A; Welty, Leah J; Hershfield, Jennifer A; Rosenbaum, Melinda S; Teplin, Linda A

    2017-02-01

    Longitudinal studies of delinquent youth have focused on criminal recidivism, not on psychosocial outcomes in adulthood. This omission is critical because after detention most youth return to the community, where they become the responsibility of pediatric health care professionals. To investigate 8 positive outcomes among delinquent youth 5 and 12 years after detention, focusing on sex and racial/ethnic differences. In the Northwestern Juvenile Project, a longitudinal US study of long-term outcomes of delinquent youth after detention, participants were interviewed in detention between November 20, 1995, and June 14, 1998, and reinterviewed up to 9 times during the 12-year study period, through May 12, 2011. Data analysis was conducted between November 18, 2013, and July 25, 2016. Juvenile detention. Achievement of positive outcomes in 8 domains: educational attainment, residential independence, gainful activity, desistance from criminal activity, mental health, abstaining from substance abuse, interpersonal functioning, and parenting responsibility. Outcomes were assessed with widely used measures supplemented by correctional records. The study included 1829 youth at baseline (1172 males and 657 females; mean [SD] age, 14.9 [1.4] years). At the end of the study, 1520 (83.1%) of the original sample remained (944 males and 576 females; mean [SD] age, 27.6 [1.4] years). Twelve years after detention, females were more likely than males to have positive outcomes for gainful activity (odds ratio [OR], 2.53; 95% CI, 1.86-3.44), desistance from criminal activity (OR, 5.89; 95% CI, 4.38-7.92), residential independence (OR, 3.41; 95% CI, 2.57-4.52), parenting responsibility (OR, 18.65; 95% CI, 12.29-28.30), and mental health (OR, 1.48; 95% CI, 1.13-1.92). Twelve years after detention, only 21.9% of males and 54.7% of females had achieved more than half of the outcomes. As youth aged, the number of positive outcomes increased only modestly (mean increase for males, 0.37; 95

  4. Lipid-absorbing Polymers

    NASA Technical Reports Server (NTRS)

    Marsh, H. E., Jr.; Wallace, C. J.

    1973-01-01

    The removal of bile acids and cholesterol by polymeric absorption is discussed in terms of micelle-polymer interaction. The results obtained with a polymer composed of 75 parts PEO and 25 parts PB plus curing ingredients show an absorption of 305 to 309%, based on original polymer weight. Particle size effects on absorption rate are analyzed. It is concluded that crosslinked polyethylene oxide polymers will absorb water, crosslinked polybutadiene polymers will absorb lipids; neither polymer will absorb appreciable amounts of lipids from micellar solutions of lipids in water.

  5. Colorful solar selective absorber integrated with different colored units.

    PubMed

    Chen, Feiliang; Wang, Shao-Wei; Liu, Xingxing; Ji, Ruonan; Li, Zhifeng; Chen, Xiaoshuang; Chen, Yuwei; Lu, Wei

    2016-01-25

    Solar selective absorbers are the core part for solar thermal technologies such as solar water heaters, concentrated solar power, solar thermoelectric generators and solar thermophotovoltaics. Colorful solar selective absorber can provide new freedom and flexibility beyond energy performance, which will lead to wider utilization of solar technologies. In this work, we present a monolithic integration of colored solar absorber array with different colors on a single substrate based on a multilayered structure of Cu/TiN(x)O(y)/TiO(2)/Si(3)N(4)/SiO(2). A colored solar absorber array with 16 color units is demonstrated experimentally by using combinatorial deposition technique via changing the thickness of SiO(2) layer. The solar absorptivity and thermal emissivity of all the color units is higher than 92% and lower than 5.5%, respectively. The colored solar selective absorber array can have colorful appearance and designable patterns while keeping high energy performance at the same time. It is a new candidate for a number of solar applications, especially for architecture integration and military camouflage.

  6. Mushroom plasmonic metamaterial infrared absorbers

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Ogawa, Shinpei, E-mail: Ogawa.Shimpei@eb.MitsubishiElectric.co.jp; Fujisawa, Daisuke; Hata, Hisatoshi

    2015-01-26

    There has been a considerable amount of interest in the development of various types of electromagnetic wave absorbers for use in different wavelength ranges. In particular, infrared (IR) absorbers with wavelength selectivity can be applied to advanced uncooled IR sensors, which would be capable of identifying objects through their radiation spectrum. In the present study, mushroom plasmonic metamaterial absorbers (MPMAs) for the IR wavelength region were designed and fabricated. The MPMAs consist of a periodic array of thin metal micropatches connected to a thin metal plate with narrow silicon (Si) posts. A Si post height of 200 nm was achieved bymore » isotropic XeF{sub 2} etching of a thin Si layer sandwiched between metal plates. This fabrication procedure is relatively simple and is consistent with complementary metal oxide semiconductor technology. The absorption spectra of the fabricated MPMAs were experimentally measured. In addition, theoretical calculations of their absorption properties were conducted using rigorous coupled wave analysis. Both the calculated and measured absorbance results demonstrated that these MPMAs can realize strong selective absorption at wavelengths beyond the period of the array by varying the micropatch width. Absorbance values greater than 90% were achieved. Dual- or single-mode absorption can also be selected by varying the width of the Si posts. Pixel structures using such MPMAs could be used as high responsivity, high resolution and fast uncooled IR sensors.« less

  7. Outcome of Treatment of Uveitic Macular Edema: The Multicenter Uveitis Steroid Treatment Trial 2-Year Results.

    PubMed

    Tomkins-Netzer, Oren; Lightman, Susan; Drye, Lea; Kempen, John; Holland, Gary N; Rao, Narsing A; Stawell, Richard J; Vitale, Albert; Jabs, Douglas A

    2015-11-01

    To evaluate the 2-year outcomes of uveitic macular edema. Longitudinal follow-up of a randomized cohort. At baseline, 148 eyes of 117 patients enrolled in the Multicenter Uveitis Steroid Treatment (MUST) Trial had macular edema, and 134 eyes of 108 patients completed 2-year follow-up. Patients enrolled in the study were randomized to either systemic immunosuppression or intravitreal fluocinolone acetonide implant therapy. Macular edema was defined as thickening of the retina (center point thickness≥240 μm) on time-domain optical coherence tomography (OCT) of macula. Improvement in macular edema (≥20% reduction in central point thickness on OCT), resolution of macular edema (normalization of thickness on OCT), and best-corrected visual acuity (BCVA). Between randomization and 2-years' follow-up, 62% and 25% of eyes in the systemic and implant groups, respectively, received at least 1 supplemental regional corticosteroid injection. By 2-years' follow-up, macular edema improved in 71% of eyes and resolved in 60%. There were no differences between treatment groups in the proportion of eyes with macular edema improving (systemic therapy vs. implant, 65% vs. 77%; P=0.20) and resolving (52% vs. 68%; P=0.28), but eyes randomized to implant had more improvement in macular thickness (median decrease of 180 vs. 109 μm in the systemic therapy group; P=0.04). Eyes with baseline fluorescein angiographic leakage were more likely to improve than those without (76% vs. 58%; P=0.03). Overall, there was a mean 5-letter (1 line) improvement in BCVA at 2 years. Mean changes in BCVA from baseline at 2 years by macular edema response status were: resolution, +10 letters; improvement without resolution, +10 letters (P=0.92); little to no change, 6 letters (P=0.19); and worsening, -16 letters (worsening acuity; P=0.0003). About two thirds of eyes with uveitic macular edema were observed to experience improvement in the edema and visual acuity with implant or systemic treatment

  8. Incidence and Functional Outcomes of Scapholunate Diastases Associated Distal Radius Fractures: A 2-year Follow-Up Scapholunate Dissociation

    PubMed Central

    Lans, Jonathan; Lasa, Alejandro; Chen, Neal C.; Jupiter, Jesse B.

    2018-01-01

    Background: The Scapholunate Interosseous Ligament (SLIL) is the first intrinsic carpal ligament to be injured in wrist trauma, present in up to 64% of the distal radius fractures. However, it remains unclear what patients develop symptoms, making primary treatment of these injuries accompanying distal radius fractures remains questionable. Objective: The aim of this study was to evaluate the functional outcomes of patients with scapholunate diastasis associated with distal radius fractures. Methods: We evaluated 391 patients with a distal radius fracture. Using Computer Tomography (CT) scans the scapholunate interval was measured. We identified 14 patients with an SLD (>3mm) of the injured wrist, which underwent a CT-scan of the contralateral wrist. To evaluate the functional outcomes at a mean follow up of 136±90 weeks, we used the Quick Disabilities of the Arm, Shoulder and Hand (qDASH) Score. Results: There were 8 patients with bilateral SLD and 6 patients with unilateral SLD. Five patients had a qDASH score of 0 and one patient showed a qDASH score of 18.2. The patient with a poor score had bilateral preexisting osteoarthritis of the wrist. No patient had additional surgery of the SLIL. Conclusion: In patients with distal radius fractures, more than half of the 14 patients with an SL gap on CT had widening on the contralateral side. It is therefore worthwhile to image the contralateral wrist before diagnosing a SLD. The patients with unilateral SLD should not be surgically treated at initial presentation because they may have good functional outcomes after a follow up of 2 years. PMID:29456778

  9. Comparison of Five-Year Outcome of Percutaneous Coronary Intervention With Coronary Artery Bypass Grafting in Triple-Vessel Coronary Artery Disease (from the Coronary Revascularization Demonstrating Outcome Study in Kyoto PCI/CABG Registry Cohort-2).

    PubMed

    Shiomi, Hiroki; Morimoto, Takeshi; Furukawa, Yutaka; Nakagawa, Yoshihisa; Tazaki, Junichi; Sakata, Ryuzo; Okabayashi, Hitoshi; Hanyu, Michiya; Shimamoto, Mitsuomi; Nishiwaki, Noboru; Komiya, Tatsuhiko; Kimura, Takeshi

    2015-07-01

    Studies evaluating long-term (≥5 years) outcomes of percutaneous coronary intervention (PCI) using drug-eluting stents compared with coronary artery bypass grafting (CABG) in patients with triple-vessel coronary artery disease (TVD) are still limited. We identified 2,978 patients with TVD (PCI: n = 1,824, CABG: n = 1,154) of 15,939 patients with first coronary revascularization enrolled in the Coronary Revascularization Demonstrating Outcome Study in Kyoto PCI/CABG Registry Cohort-2. The primary outcome measure in the present analysis was a composite of death, myocardial infarction (MI), and stroke. Median follow-up duration for the surviving patients was 1,973 days (interquartile range 1,700 to 2,244). The cumulative 5-year incidence of death/MI/stroke was significantly higher in the PCI group than in the CABG group (28.2% vs 24.0%, log-rank p = 0.006). After adjusting for confounders, the excess risk of PCI relative to CABG for death/MI/stroke remained significant (hazard ratio [HR] 1.38, 95% confidence interval [CI] 1.13 to 1.68, p = 0.002). The excess risks of PCI relative to CABG for all-cause death, MI, and any coronary revascularization were also significant (HR 1.38, 95% CI 1.10 to 1.74, p = 0.006; HR 2.81, 95% CI 1.69 to 4.66, p <0.001; and HR 4.10, 95% CI 3.32 to 5.06, p <0.001, respectively). The risk for stroke was not significantly different between the PCI and CABG groups (HR 0.88, 95% CI 0.61 to 1.26, p = 0.48). There were no interactions for the primary outcome measure between the mode of revascularization (PCI or CABG) and the subgroup factors such as age, diabetes, and Synergy Between PCI With Taxus and Cardiac Surgery score. In conclusion, CABG compared with PCI was associated with better long-term outcome in patients with TVD. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Randomized controlled trial of oxygen saturation targets in very preterm infants: two year outcomes.

    PubMed

    Darlow, Brian A; Marschner, Simone L; Donoghoe, Mark; Battin, Malcolm R; Broadbent, Roland S; Elder, Mark J; Hewson, Michael P; Meyer, Michael P; Ghadge, Alpana; Graham, Patricia; McNeill, Nicolette J; Kuschel, Carl A; Tarnow-Mordi, William O

    2014-07-01

    To assess whether an oxygen saturation (Spo2) target of 85%-89% compared with 91%-95% reduced the incidence of the composite outcome of death or major disability at 2 years of age in infants born at <28 weeks' gestation. A total 340 infants were randomized to a lower or higher target from <24 hours of age until 36 weeks' gestational age. Blinding was achieved by targeting a displayed Spo2 of 88%-92% using a saturation monitor offset by ±3% within the range 85%-95%. True saturations were displayed outside this range. Follow-up at 2 years' corrected age was by pediatric examination and formal neurodevelopmental assessment. Major disability was gross motor disability, cognitive or language delay, severe hearing loss, or blindness. The primary outcome was known for 335 infants with 33 using surrogate language information. Targeting a lower compared with a higher Spo2 target range had no significant effect on the rate of death or major disability at 2 years' corrected age (65/167 [38.9%] vs 76/168 [45.2%]; relative risk 1.15, 95% CI 0.90-1.47) or any secondary outcomes. Death occurred in 25 (14.7%) and 27 (15.9%) of those randomized to the lower and higher target, respectively, and blindness in 0% and 0.7%. Although there was no benefit or harm from targeting a lower compared with a higher saturation in this trial, further information will become available from the prospectively planned meta-analysis of this and 4 other trials comprising a total of nearly 5000 infants. Copyright © 2014 Elsevier Inc. All rights reserved.

  11. UV absorbers for cellulosic apparels: A computational and experimental study

    NASA Astrophysics Data System (ADS)

    Sahar, Anum; Ali, Shaukat; Hussain, Tanveer; Irfan, Muhammad; Eliasson, Bertil; Iqbal, Javed

    2018-01-01

    Two triazine based Ultra Violet (UV) absorbers Sulfuric acid mono-(2-{4-[4-chloro-6-(4-{4-chloro-6-[4-(2-sulfooxy-ethanesulfonyl)-phenylamino]-[1,3,5] triazin-2-ylamino-phenylamino)-[1,3,5]triazin-2-ylamino]-benzenesulfonyl}-ethyl) ester (1a) and 4-{4-chloro-6-[4-(2-sulfooxy-ethanesulfonyl)-phenylamino]-[1,3,5] triazin-2-ylamino}-2-[4-chloro-6-(2-sulfooxy-ethanesulfonyl)-[1,3,5]triazin-2-ylamino]-benzenesulfonic acid (2a) with different substituents were designed computationally. The influence of different substituents on the electrochemical properties and UV spectra of the absorbers was investigated. The presence of electron deficient unit in 1a to the molecular core significantly reduces the LUMO levels and energy gap. The designed absorbers were synthesized via condensation reaction and characterized by UV-Vis, FT-IR, MS studies. The performance of synthesized compounds as UV absorbers and their fastness properties were assessed by finishing the cotton fabric through exhaust method at different concentration and results appeared in good range.

  12. The Mark Coventry Award: Custom Cutting Guides Do Not Improve Total Knee Arthroplasty Clinical Outcomes at 2 Years Followup.

    PubMed

    Nam, Denis; Park, Andrew; Stambough, Jeffrey B; Johnson, Staci R; Nunley, Ryan M; Barrack, Robert L

    2016-01-01

    Custom cutting guides (CCGs; sometimes called patient-specific instrumentation [PSI]) in total knee arthroplasty (TKA) use preoperative three-dimensional imaging to fabricate cutting blocks specific to a patient's native anatomy. The purposes of this study were to determine if CCGs (1) improve clinical outcomes as measured by UCLA activity, SF-12, and Oxford knee scores; and (2) coronal mechanical alignment versus standard alignment guides. This was a retrospective cohort study of patients undergoing primary TKA using the same cruciate-retaining, cemented TKA system between January 2009 and April 2012. Patients were included if they were candidates for a unilateral, cruciate-retaining TKA and met other prespecified criteria; patients were allowed to self-select either an MRI-based CCG procedure or standard TKA. Ninety-seven of 120 (80.8%) patients in the standard and 104 of 124 (83.9%, p = 0.5) in the CCG cohort with a minimum of 1-year followup were available for analysis. The first 95 patients in the standard (mean followup, 3 years; range, 1-4 years) and CCG (mean followup, 2 years; range, 1-4 years) cohorts were compared. The alignment goal for all TKAs was a hip-knee-ankle (HKA) angle of 0°. UCLA, SF-12, and Oxford knee scores were collected preoperatively and at each patient's most recent followup visit. Postoperative, rotationally controlled coronal scout CT scans were used to measure HKA alignment. Independent-sample t-tests and chi-square tests were used for comparisons with a p value ≤ 0.05 considered significant. At the most recent followup, no differences were present between the two cohorts for range of motion (114° ± 14° in CCG versus 115° ± 15° in standard, p = 0.7), UCLA (6 ± 2 in CCG versus 6 ± 2 in standard, p = 0.7), SF-12 physical (44 ± 12 in CCG versus 41 ± 12 in standard, p = 0.07), or Oxford knee scores (39 ± 9 in CCG versus 37 ± 10 in standard, p = 0.1). No differences were present for the incremental improvement in the UCLA

  13. Two-Year Outcomes of a Population-Based Intervention for Preschool Language Delay: An RCT.

    PubMed

    Wake, Melissa; Levickis, Penny; Tobin, Sherryn; Gold, Lisa; Ukoumunne, Obioha C; Goldfeld, Sharon; Zens, Naomi; Le, Ha N D; Law, James; Reilly, Sheena

    2015-10-01

    We have previously shown short-term benefits to phonology, letter knowledge, and possibly expressive language from systematically ascertaining language delay at age 4 years followed by the Language for Learning intervention. Here, we report the trial's definitive 6-year outcomes. Randomized trial nested in a population-based ascertainment. Children with language scores >1.25 SD below the mean at age 4 were randomized, with intervention children receiving 18 1-hour home-based therapy sessions. Primary outcome was receptive/expressive language. Secondary outcomes were phonological, receptive vocabulary, literacy, and narrative skills; parent-reported pragmatic language, behavior, and health-related quality of life; costs of intervention; and health service use. For intention-to-treat analyses, trial arms were compared using linear regression models. Of 1464 children assessed at age 4, 266 were eligible and 200 randomized; 90% and 82% of intervention and control children were retained respectively. By age 6, mean language scores had normalized, but there was little evidence of a treatment effect for receptive (adjusted mean difference 2.3; 95% confidence interval [CI] -1.2 to 5.7; P = .20) or expressive (0.8; 95% CI -1.6 to 3.2; P = .49) language. Of the secondary outcomes, only phonological awareness skills (effect size 0.36; 95% CI 0.08-0.65; P = .01) showed benefit. Costs were higher for intervention families (mean difference AU$4276; 95% CI: $3424 to $5128). Population-based intervention targeting 4-year-old language delay was feasible but did not have lasting impacts on language, possibly reflecting resolution in both groups. Long-term literacy benefits remain possible but must be weighed against its cost. Copyright © 2015 by the American Academy of Pediatrics.

  14. Pelvic floor muscle training for female stress urinary incontinence: Five years outcomes.

    PubMed

    Beyar, Netta; Groutz, Asnat

    2017-01-01

    To evaluate the clinical status, lower urinary tract symptoms (LUTS) and quality of life (QOL) 5 years after completion of a pelvic floor muscle training (PFMT) program for female stress urinary incontinence (SUI). Two hundred and eight consecutive women who underwent a guided PFMT program as first-line management of SUI were invited to participate in a questionnaire-based outcome study 5 years after treatment. Primary outcome measures comprised of adherence to PFMT, interim surgery for SUI, and patients' self-assessment of LUTS and QOL. One hundred and thirty-two (63%) women completed all questionnaires, 55 of whom (41.7%, mean age 52.1 ± 10.8) reported adherence to PFMT, 75 (56.8%, mean age 49.8 ± 10.8) discontinued training, and two (1.5%) underwent surgery. Further analysis of the 76 non-responders revealed six more patients who underwent surgery. Thus, overall, eight patients (3.8% of the original cohort) underwent surgery within 5 years after completion of the training program. Except for those who underwent surgery, almost all women reported SUI, however their ICIQ-UI scores for frequency and amount of leakage were low (2.2 ± 0.9, 1.18 ± 1.04, respectively) and I-QOL score was high (96.2 ± 13.6). All investigated parameters and domains, in each of the three questionnaires and among all women, consistently demonstrated low severity of LUTS and relatively high continence-associated QOL. There were no statistically significant differences in favor of adherence to PFMT. Although relatively high rates of 5-year adherence to training were demonstrated among our patients, this adherence was not associated with superior treatment outcomes. Further studies are needed to establish the long-term efficacy of PFMT for SUI. Neurourol. Urodynam. 36:132-135, 2017. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

  15. Bench Scale Process for Low Cost CO 2 Capture Using a Phase-Changing Absorbent: Final Scientific/Technical Report

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Westendorf, Tiffany; Buddle, Stanlee; Caraher, Joel

    The objective of this project is to design and build a bench-scale process for a novel phase-changing aminosilicone-based CO 2-capture solvent. The project will establish scalability and technical and economic feasibility of using a phase-changing CO 2-capture absorbent for post-combustion capture of CO 2 from coal-fired power plants. The U.S. Department of Energy’s goal for Transformational Carbon Capture Technologies is the development of technologies available for demonstration by 2025 that can capture 90% of emitted CO 2 with at least 95% CO 2 purity for less than $40/tonne of CO 2 captured. In the first budget period of the project,more » the bench-scale phase-changing CO2 capture process was designed using data and operating experience generated under a previous project (ARPA-e project DE-AR0000084). Sizing and specification of all major unit operations was completed, including detailed process and instrumentation diagrams. The system was designed to operate over a wide range of operating conditions to allow for exploration of the effect of process variables on CO 2 capture performance. In the second budget period of the project, individual bench-scale unit operations were tested to determine the performance of each of each unit. Solids production was demonstrated in dry simulated flue gas across a wide range of absorber operating conditions, with single stage CO 2 conversion rates up to 75mol%. Desorber operation was demonstrated in batch mode, resulting in desorption performance consistent with the equilibrium isotherms for GAP-0/CO 2 reaction. Important risks associated with gas humidity impact on solids consistency and desorber temperature impact on thermal degradation were explored, and adjustments to the bench-scale process were made to address those effects. Corrosion experiments were conducted to support selection of suitable materials of construction for the major unit operations in the process. The bench scale unit operations were assembled into

  16. Levels of outdoor PM 2.5, absorbance and sulphur as surrogates for personal exposures among post-myocardial infarction patients in Barcelona, Spain

    NASA Astrophysics Data System (ADS)

    Jacquemin, Bénédicte; Lanki, Timo; Sunyer, Jordi; Cabrera, Laia; Querol, Xavier; Bellander, Tom; Moreno, Natalia; Peters, Annette; Pey, Jorge; Pekkanen, Juha

    Outdoor levels of fine particles (PM 2.5; particles <2.5 μm) have been associated with cardiovascular health. Persons with existing cardiovascular disease have been suggested to be especially vulnerable. It is unclear, how well outdoor concentrations of PM 2.5 and its constituents measured at a central site reflect personal exposures in Southern European countries. The objective of the study was to assess the relationship between outdoor and personal concentrations of PM 2.5, absorbance and sulphur among post-myocardial infarction patients in Barcelona, Spain. Thirty-eight subjects carried personal PM 2.5 monitors for 24-h once a month (2-6 repeated measurements) between November 2003 and June 2004. PM 2.5 was measured also at a central outdoor monitoring site. Light absorbance (a proxy for elemental carbon) and sulphur content of filter samples were determined as markers of combustion originating and long-range transported PM 2.5, respectively. There were 110, 162 and 88 measurements of PM 2.5, absorbance and sulphur, respectively. Levels of outdoor PM 2.5 (median 17 μg m 3) were lower than personal PM 2.5 even after excluding days with exposure to environmental tobacco smoke (ETS) (median after exclusion 27 μg m 3). However, outdoor concentrations of absorbance and sulphur were similar to personal concentrations after exclusion of ETS. When repeated measurements were taken into account, there was a statistically significant association between personal and outdoor absorbance when adjusting for ETS (slope 0.66, p<0.001), but for PM 2.5 the association was weaker (slope 0.51, p=0.066). Adjustment for ETS had little effect on the respective association of S (slope 0.69, p<0.001). Our results suggest that outdoor measurements of absorbance and sulphur can be used to estimate both the daily variation and levels of personal exposures also in Southern European countries, especially when exposure to ETS has been taken into account. For PM 2.5, indoor sources need to

  17. Liraglutide and Renal Outcomes in Type 2 Diabetes.

    PubMed

    Mann, Johannes F E; Ørsted, David D; Brown-Frandsen, Kirstine; Marso, Steven P; Poulter, Neil R; Rasmussen, Søren; Tornøe, Karen; Zinman, Bernard; Buse, John B

    2017-08-31

    In a randomized, controlled trial that compared liraglutide, a glucagon-like peptide 1 analogue, with placebo in patients with type 2 diabetes and high cardiovascular risk who were receiving usual care, we found that liraglutide resulted in lower risks of the primary end point (nonfatal myocardial infarction, nonfatal stroke, or death from cardiovascular causes) and death. However, the long-term effects of liraglutide on renal outcomes in patients with type 2 diabetes are unknown. We report the prespecified secondary renal outcomes of that randomized, controlled trial in which patients were assigned to receive liraglutide or placebo. The secondary renal outcome was a composite of new-onset persistent macroalbuminuria, persistent doubling of the serum creatinine level, end-stage renal disease, or death due to renal disease. The risk of renal outcomes was determined with the use of time-to-event analyses with an intention-to-treat approach. Changes in the estimated glomerular filtration rate and albuminuria were also analyzed. A total of 9340 patients underwent randomization, and the median follow-up of the patients was 3.84 years. The renal outcome occurred in fewer participants in the liraglutide group than in the placebo group (268 of 4668 patients vs. 337 of 4672; hazard ratio, 0.78; 95% confidence interval [CI], 0.67 to 0.92; P=0.003). This result was driven primarily by the new onset of persistent macroalbuminuria, which occurred in fewer participants in the liraglutide group than in the placebo group (161 vs. 215 patients; hazard ratio, 0.74; 95% CI, 0.60 to 0.91; P=0.004). The rates of renal adverse events were similar in the liraglutide group and the placebo group (15.1 events and 16.5 events per 1000 patient-years), including the rate of acute kidney injury (7.1 and 6.2 events per 1000 patient-years, respectively). This prespecified secondary analysis shows that, when added to usual care, liraglutide resulted in lower rates of the development and

  18. [Has the pregnancy outcome of women with pregestational diabetes mellitus improved in ten years?].

    PubMed

    Čechurová, Daniela; Krčma, Michal; Jankovec, Zdeněk; Dort, Jiří; Turek, Jan; Lacigová, Silvie; Rušavý, Zdeněk

    2015-02-01

    In spite of progress in medicine, studies from a number of countries indicate steadily increased risk of perinatal morbidity and mortality in the offspring of diabetic mothers. No data regarding the pregnancy outcome in women with diabetes mellitus type 1 and 2 (pregestational DM) have been published in the Czech Republic. The aim of the study was to evaluate the pregnancy course of women with pregestational DM and outcome of their offspring and to assess whether it has improved in ten years. A retrospective evaluation of pregnancy outcome of pregestational DM women followed up in the University Hospital Pilsen in years 2000-2009 (Group A, n = 107) and comparison with the period 1990-1997 (Group B, n = 39) were performed. Wilcoxon non-paired test, contingency tables, step-wise logistic regression and step-wise linear multiple regression methods were used for statistical analyses. Data is presented as median (interquartile range). Women from the Group A were older 28 (25, 31) vs 25 (22, 27) years, p = 0.01. Otherwise, the groups did not statistically significantly differ in diabetes duration, BMI, and representation of women with type 2 diabetes. A better glycemic control (HbA1c, mmol/mol) was achieved in the Group A in all trimesters - 1st trimester: 59 (47, 67) vs 66 (56, 76), 2nd trimester: 46 (40, 52) vs 54 (48, 59) and 3rd trimester: 46 (40, 51) vs 53 (47, 60), p = 0.01. The caesarean section rate decreased (65.2 % vs 87.5 %, p < 0.05). The incidence of the respiratory distress syndrome after adjustment for age and diabetes duration also decreased (8.9 % vs 18.2 %, p < 0.05). A decreasing trend in the rate of premature delivery before 34th week of gestation (1.1 % vs 6.3 %) and neonatal mortality (1.1 % vs 2.9 %) was observed, however, the differences were not statistically significant. The achieved improved glycemic control led to only a partial improvement in the course of pregnancy and outcome of the offspring of diabetic mothers.

  19. Beyond Detention: A 12-Year Longitudinal Study of Positive Outcomes in Delinquent Youth

    PubMed Central

    Abram, Karen M.; Azores-Gococo, Nicole M.; Emanuel, Kristin M.; Aaby, David A.; Welty, Leah J.; Hershfield, Jennifer A.; Rosenbaum, Melinda S.; Teplin, Linda A.

    2017-01-01

    Importance Longitudinal studies of delinquent youth have focused on criminal recidivism, not on psychosocial outcomes in adulthood. This omission is critical because most youth return to the community where they become the responsibility of pediatric health care providers. Objective To investigate 8 positive outcomes among delinquent youth 5 and 12 years after detention, focusing on sex and racial/ethnic differences. Design The Northwestern Juvenile Project, the first comprehensive longitudinal US study of long-term outcomes of delinquent youth after detention (n=1829). Youth were interviewed in detention and reinterviewed up to 9 times over 12 years. Setting Project staff conducted face-to-face structured interviews at the Cook County Juvenile Temporary Detention Center (Chicago, Illinois) between November 20, 1995, and June 14, 1998. At follow-ups, participants were interviewed wherever they were living, in the community or in correctional facilities. Participants Stratified random sample, 1172 males and 657 females (1005 African Americans, 524 Hispanics, 296 non-Hispanic whites, and 4 of other race/ethnicity). At baseline, median age was 15 years. Twelve years later, at median age 28 years, 1520 (83.1%) of the original sample remained. Main Outcome and Measures Achievement of positive outcomes in 8 domains: educational attainment, residential independence, gainful activity, desistance from criminal activity, mental health, abstaining from substance abuse, interpersonal functioning, and parenting responsibility. Outcomes were assessed with widely used measures supplemented by correctional records. Results Females were significantly more likely than males to achieve most positive outcomes. Twelve years after detention, only 21.9% of males and 54.7% of females had achieved more than half of the outcomes. As youth aged, the number of positive outcomes increased only modestly. Among males, non-Hispanic whites were significantly more likely to achieve most positive

  20. Absorber modeling for NGCC carbon capture with aqueous piperazine.

    PubMed

    Zhang, Yue; Freeman, Brice; Hao, Pingjiao; Rochelle, Gary T

    2016-10-20

    A hybrid system combining amine scrubbing with membrane technology for carbon capture from natural gas combined cycle (NGCC) power plants is proposed in this paper. In this process, the CO 2 in the flue gas can be enriched from 4% to 18% by the membrane, and the amine scrubbing system will have lower capture costs. Aqueous piperazine (PZ) is chosen as the solvent. Different direct contact cooler (DCC) options, multiple absorber operating conditions, optimal intercooling designs, and different cooling options have been evaluated across a wide range of inlet CO 2 . Amine scrubbing without DCC is a superior design for NGCC carbon capture. Pump-around cooling at the bottom of the absorber can effectively manage the temperature of the hot flue gas, and still be effective for CO 2 absorption. The absorber gas inlet must be designed to avoid excessive localized temperature and solvent evaporation. When the inlet CO 2 increases from 4% to 18%, total absorber CAPEX decreases by 60%; another 10% of the total absorber CAPEX can be saved by eliminating the DCC. In-and-out intercooling works well for high CO 2 , while pump-around intercooling is more effective for low CO 2 . Dry cooling requires more packing and energy but appears to be technically and economically feasible if cooling water availability is limited.

  1. Medium-term outcomes and complications after total replacement of the temporomandibular joint. Prospective outcome analysis after 3 and 5 years.

    PubMed

    Gruber, E A; McCullough, J; Sidebottom, A J

    2015-05-01

    In this prospective analysis, we assess the medium-term benefits, efficacy, and safety of the TMJ Concepts joint replacement system in the United Kingdom. Outcome measures of pain, maximum mouth opening, and diet were recorded preoperatively and at intervals up to 3 and 5 years. All patients who had replacement temporomandibular joints (TMJ) within a 6-year period were included. A total of 58 patients (84 joints) were followed up for 3 years (mean age 47, range 19-72) and 26 (42 joints) for 5 years (mean age 46, range 27-70). The female to male ratio was 52:6 at 3 years and 23:3 at 5 years. The most common diagnosis was degenerative disease, and the mean number of previous TMJ procedures was 2.4 (range 0-14). There were significant improvements in pain scores (7.4 reduced to 0.6 at 3 years and 0.8 at 5 years), maximum mouth opening (21.0-35.5mm at 3 years and 23.8-33.7mm at 5 years), and dietary scores (4.1-9.7 at 3 years and 3.7-9.6 at 5 years). Revision operations were required in 2 patients (not included in the outcome data) for biofilm infection of the prosthesis secondary to local infection in the head and neck. One patient had weakness of the temporal branch of the facial nerve that needed correction. TMJ replacement is an effective form of management for an irreparably damaged joint, particularly in cases of ankylosis. It lessens pain and improves function with minimal long-term morbidity. Copyright © 2014 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  2. Outcomes of aortopulmonary window repair in children: 33 years of experience.

    PubMed

    Naimo, Phillip S; Yong, Matthew S; d'Udekem, Yves; Brizard, Christian P; Kelly, Andrew; Weintraub, Robert; Konstantinov, Igor E

    2014-11-01

    The purpose of this study was to assess the outcomes of children undergoing repair of aortopulmonary window (APW). We conducted a retrospective review of all children (n=43) who underwent surgical repair of APW between 1980 and 2013. Median age at surgery was 40 days (range, 13 to 125). Simple APW was present in 15 of 43 patients (35%), and 28 of 43 patients (65%) patients had concomitant cardiovascular anomalies. The aorta was repaired by direct suturing in 36 patients (84%) patients and patching in 7 patients (16%). The main pulmonary artery was repaired by direct suturing in 22 patients (51%) patients and by patching in 21 (49%). Cardiopulmonary bypass was used in 42 of the 43 patients (97.7%). Single-staged repair of concomitant cardiovascular anomalies was undertaken in 26 of 28 patients (93%). Only 2 of the 28 patients (7%) underwent repair of interrupted aortic arch before APW repair. Operative mortality was 6.7% (1 of 15 patients) among patients with simple APW and 18% (5 of 28 patients) among patients with concomitant anomalies. Operative weight less than 2.5 kg was associated with mortality on univariable analysis (p=0.02). Median follow-up was 10.1 years (range, 0.17 to 24.2). There were no late deaths. Overall survival was 86% (95% confidence interval: 71.3 to 94.2) at 10 years. Freedom from reoperation was 95.3% (95% confidence interval: 86.2 to 99.9) at 10 years. At last follow-up, all patients were in New York Heart Association functional class I/II. Survival beyond discharge from the hospital is associated with excellent outcomes. Copyright © 2014 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  3. Black phosphorus saturable absorber for a diode-pumped passively Q-switched Er:CaF2 mid-infrared laser

    NASA Astrophysics Data System (ADS)

    Li, Chun; Liu, Jie; Guo, Zhinan; Zhang, Han; Ma, Weiwei; Wang, Jingya; Xu, Xiaodong; Su, Liangbi

    2018-01-01

    A multilayer black phosphorus, as a novel two dimensional saturable absorber, has superb saturable absorption properties for a Er:CaF2 solid-state pulse laser. The pulse laser is realized at mid-infrared region with the passively Q-switched technology by a diode-pumping. The high-quality black phosphorus saturable absorber is fabricated by liquid phase exfoliation method. The pulse laser generates the pulses operation with the pulse duration of 954.8 ns, the repetition rate of 41.93 kHz, the pulse energy of 4.25 μJ and the peak power of 4.45 W. Our work demonstrates that black phosphorus could be used as a kind of efficient mid-infrared region optical absorber for ultrafast photonics.

  4. Tuberculosis treatment outcome and predictors in northern Ethiopian prisons: a five-year retrospective analysis.

    PubMed

    Adane, Kelemework; Spigt, Mark; Dinant, Geert-Jan

    2018-02-20

    The prison situations are notorious for causing interruptions of tuberculosis (TB) treatment and occurrence of unfavorable outcomes. In Ethiopian prisons, though TB treatment programs exist, treatment outcome results and factors contributing to unsuccessful outcome are not well documented. In this study, we assessed the treatment outcome of TB cases and identified risk factors for unsuccessful outcome in northern Ethiopian prisons. A retrospective record review was conducted for all prisoners diagnosed with TB between September 2011 and August 2015. Outcome variables were defined following WHO guidelines. Out of the 496 patients, 11.5% were cured, 68% completed treatment, 2.5% were lost to follow-up, 1.6% were with a treatment failure, 1.4% died, and 15% were transferred out. All transferred out or released prisoners were not appropriately linked to health facilities and might be lost to treatment follow-up. The overall treatment success rate (TSR) of the 5 years was 94% among the patients who were not transferred out. The odds of unsuccessful outcome were 4.68 times greater among re-treatment cases compared to the newly treated cases. The year of treatment was also associated with variations in TSR; those treated during the earlier year were more likely to have unsuccessful outcome. Sputum non-conversion at the second-month check-up was strongly associated with unsuccessful outcome among the smear-positive cases. The mean TSR of the prisoners in the study prisons was quite satisfactory when gauged against the target level set by the End TB Strategy. However, the lack of appropriate linkage and tracking systems for those prisoners transferred or released before their treatment completion would have a negative implication for the national TB control program as such patients might interrupt their treatment and develop drug-resistant TB. Being in a re-treatment regimen and sputum non-conversion at the second-month check-up were significantly associated with

  5. Down the Track: TAFE Outcomes for Young People Two Years On

    ERIC Educational Resources Information Center

    Sherman, Rebecca

    2006-01-01

    Using results from the 2002 Student Outcomes Survey and a follow-up survey of these students in 2004, this report examines outcomes over time of young people aged 15-24 years who undertook technical and further education (TAFE) training in 2001. The report looks at changes in employment, wages and skill level, further study outcomes and other…

  6. Ten year experience with antiretroviral treatment in Cambodia: Trends in patient characteristics and treatment outcomes.

    PubMed

    Lay, Phirum; An, Sokkab; Soeung, Sunpiseth; Srey, Pich Sovannary; Thai, Sopheak; Lynen, Lutgarde; Griensven, Johan van

    2017-01-01

    Although HIV disease stage at ART initiation critically determines ART outcomes, few reports have longitudinally monitored this within Asia. Using prospectively collected data from a large ART program at Sihanouk Hospital Center of Hope in Cambodia, we report on the change in patient characteristics and outcomes over a ten-year period. We conducted a retrospective analysis including all adults (≥ 18 years old) starting ART from March 2003-March 2013 in a non-governmental hospital in Phnom Penh, Cambodia. The cumulative incidence of death, lost to follow-up (LTFU), attrition (death or LTFU) and first line treatment failure were calculated using Kaplan-Meier methods. Independent risk factors for these outcomes were determined using Cox regression modeling. Over the ten-year period, 3581 patients initiated ART with a median follow-up time of 4.8 years (IQR 2.8-7.2). The median age was 35 years (IQR 30-41), 54% were female. The median CD4 count at ART initiation increased from 22 cells/μL (IQR 4-129) in 2003 to 218 (IQR 57-302) in 2013. Over the 10 year period, a total of 282 (7.9%) individuals died and 433 (12.1%) were defined LTFU. Program attrition (died or LTFU) was 11.1% (95% CI: 10.1%- 12.4%) at one year, 16.3% (95% CI: 15.1%-17.6%) at three years, 19.8% (95% CI: 18.5%-21.2%) at five years and 23.3% (95% CI: 21.6-25.1) at ten years. Male sex and low baseline body mass index (BMI) were associated with increased attrition. Factors independently associated with mortality included a low baseline CD4 count, older age, male sex, low baseline BMI and hepatitis B co-infection. Individuals aged above 40 years old had an increased risk of mortality but were less likely to LTFU. There were a total of 137 individuals with first line ART failure starting second line treatment. The probability of first line failure was estimated at 2.8% (95% CI: 2.3%-3.4%) at 3 years, 4.6% (95% CI: 3.9%-5.5%) at 5 years and 7.8% (95% CI 4.8%-12.5%) at ten years of ART. The probability was

  7. One-year postpartum outcomes following a weight management intervention in pregnant women with obesity

    PubMed Central

    Vesco, Kimberly K.; Leo, Michael C.; Karanja, Njeri; Gillman, Matthew W.; McEvoy, Cindy T.; King, Janet C.; Eckhardt, Cara L.; Smith, K. Sabina; Perrin, Nancy; Stevens, Victor J.

    2016-01-01

    Objective This analysis focuses on 1-year maternal and infant follow-up of a randomized trial that tested a weight management intervention conducted during pregnancy. Methods We randomly assigned 114 women with obesity (mean BMI 36.7 kg/m2) at a mean of 15 weeks’ gestation to a weight management intervention or usual care control condition. The intervention ended at delivery and resulted in less gestational weight gain and a lower proportion of large-for-gestational age newborns among intervention compared to control participants. The primary outcome at 12 months postpartum was maternal weight. Secondary outcomes included infant weight-for-age and weight-for-length z-scores. Results At 1 year, mothers in the intervention group weighed 96.3±18.6 kg, and in the control group, 99.7±19.2 kg. There was no significant difference between groups in change in weight from randomization to 1-year postpartum (b=-0.47, 95% CI [-4.03, 3.08]. There was a significant main effect of group for infant weight-for-age z-score (b=-0.40, 95% CI [-0.75,-0.05]) but not infant weight-for-length z-scores (b=-0.20, 95% CI [-0.59,0.20]. Conclusions A gestational weight management intervention did not influence maternal weight or infant weight-for-length at 1-year postpartum. Future studies may be warranted to determine if extending prenatal interventions into the postpartum period would be beneficial for maternal and infant outcomes. PMID:27670399

  8. Novel Solution Process for Fabricating Ultra-Thin-Film Absorber Layers in Fe 2SiS 4 and Fe 2GeS 4 Photovoltaics

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Orefuwa, Samuel A.; Lai, Cheng-Yu; Dobson, Kevin D.

    2014-05-12

    Fe 2SiS 4 and Fe 2GeS 4 crystalline materials posses direct bandgaps of ~1.55 and ~1.4 eV respectively and an absorption coefficient larger than 10^5 cm–1; their theoretical potential as solar photovoltaic absorbers has been demonstrated. However, no solar devices that employ either Fe 2SiS 4 or Fe 2GeS 4 have been reported to date. In the presented work, nanoprecursors to Fe 2SiS 4 and Fe 2GeS 4 have been fabricated and employed to build ultra-thin-film layers via spray coating and rod coating methods. Temperature-dependent X-Ray diffraction analyses of nanoprecursors coatings show an unprecedented low temperature for forming crystalline Femore » 2SiS 4 and Fe 2GeS 4. Fabricating of ultra-thin-film photovoltaic devices utilizing Fe 2SiS 4 and Fe 2GeS 4 as solar absorber material is presented.« less

  9. One-Year Outcomes and Mediators of a Brief Intervention for Drug Abusing Adolescents

    PubMed Central

    Winters, Ken C.; Lee, Susanne; Botzet, Andria; Fahnhorst, Tamara; Nicholson, Ali

    2014-01-01

    Two manually-guided brief interventions were evaluated with a randomized controlled trial. Adolescents (aged 13-17 years) suspected of abusing alcohol and other drugs and their parent were randomly assigned to receive either a 2-session adolescent only (BI-A), 2-session adolescent and additional parent session (BI-AP), or assessment only control condition (CON). Adolescents were identified in a school setting and the intervention was delivered by trained counselors. Outcome analyses (N=284; 90% of those enrolled) of relative change (from intake to 12-months) and absolute status (at 12-months) revealed a general pattern of reductions in drug use behaviors, particularly with the cannabis outcome measures, in both active conditions (BI-A and BI-AP). Students in the control condition showed worse outcome compared to the BI-A and BI-AP groups. Among the four mediating variables measured at 6-months, use of additional services, motivation to change and parenting practices had significant influences on 12-month outcome; problem solving skills approached significance as a mediator. The potential value of a brief intervention for drug abusing adolescents is discussed. PMID:24955669

  10. Double-bundle PCL reconstruction using autologous hamstring tendons: outcome with a minimum 2-year follow-up.

    PubMed

    Cury, Ricardo de Paula Leite; Castro Filho, Rômulo Neves; Sadatsune, Daniel Akira; do Prado, Davi Ribeiro; Gonçalves, Ricardo José Peruzzo; Mestriner, Marcos Barbieri

    2017-01-01

    To present the outcomes of posterior cruciate ligament (PCL) double-bundle reconstruction using autologous hamstring tendons, with a minimum follow-up of two years. Evaluation of 16 cases of PCL injury that underwent double-bundle reconstruction with autogenous hamstring tendons, between 2011 and 2013. The final sample consisted of 16 patients, 15 men and one woman, with a mean age of 31 years (21-49). The predominant mechanism was motorcycle accident in half of the cases. There was a mean interval of 15 months between the time of lesion and the surgery (three to 52 months). Five lesions were isolated and 11, associated. Clinical evaluation, application of validated scores, and measurements with use of the KT-1000 were performed. The analysis showed a mean preoperative Lysholm score of 50 points (28-87), progressing to 94 points (85-100) postoperatively. The IKDC score also demonstrated improvement. In the preoperative evaluation, four and 12 patients were respectively classified as C (abnormal) and D (very unusual), and in the postoperative evaluation six as A (normal) and ten as B (close to normal). In the post-operative evaluation by KT1000 arthrometer, 13 patients showed difference between 0-2 mm and 3 between 3 and 5 mm, when compared with the contralateral side. Autologous hamstring tendons are a viable option in double-bundle reconstruction of the PCL, with good clinical results in a minimum follow-up of two years.

  11. Initial CSF total tau correlates with 1-year outcome in patients with traumatic brain injury.

    PubMed

    Ost, M; Nylén, K; Csajbok, L; Ohrfelt, A Olsson; Tullberg, M; Wikkelsö, C; Nellgård, P; Rosengren, L; Blennow, K; Nellgård, B

    2006-11-14

    We investigated if tau, microtubular binding protein, in serum and ventricular CSF (vCSF) in patients with severe traumatic brain injury (TBI) during the initial posttraumatic days correlated to 1-year outcome. Patients with severe TBI (n = 39, Glasgow Coma Scale score year Extended Glasgow Outcome Scale (GOSE), the NIH Stroke Scale (NIHSS) neurologic status, and the Bartel Daily Living Index. Patients (n = 20) with normal pressure hydrocephalus (NPH) served as reference. Higher levels of tau were found in TBI patients vs patients with NPH. A correlation was found between initial vCSF total tau and GOSE levels (R = 0.42, p < 0.001) but not between vCSF total tau and NIHSS or Bartel scores at 1 year. A vCSF total tau level of >2,126 pg/mL on days 2 to 3 discriminated between dead and alive (sensitivity of 100% and a specificity of 81%). A vCSF total tau level of >702 pg/mL on days 2 to 3 discriminated between bad (GOSE 1 to 4) and good (GOSE 5 to 8) outcome (sensitivity of 83% and a specificity of 69%). Patients with GOSE 1 (dead) had higher vCSF total tau levels on days 2 to 3 (p < 0.001) vs both surviving patients (GOSE 2 to 8) and those with NPH. Total tau was not detected in serum throughout the study. The increase in ventricular CSF (vCSF) total tau probably reflects axonal damage, known to be a central pathologic mechanism in traumatic brain injury (TBI). These results suggest that vCSF total tau may be an important early biochemical neuromarker for predicting long-term outcome in patients with a severe TBI.

  12. Sellers works at the CO2 Absorber Panel Door in the MDDK during STS-132

    NASA Image and Video Library

    2010-05-15

    S132-E-007167 (15 May 2010) --- NASA astronaut Piers Sellers, STS-132 mission specialist, works at the Carbon Dioxide absorber panel door on the middeck of the Earth-orbiting space shuttle Atlantis during Flight Day 2 activities. Photo credit: NASA or National Aeronautics and Space Administration

  13. Infant Information Processing in Relation to Six-Year Cognitive Outcomes.

    ERIC Educational Resources Information Center

    Rose, Susan A.; And Others

    1992-01-01

    Infants' visual recognition memory (VRM) at seven months was associated with their general intelligence, language proficiency, reading and quantitative skills, and perceptual organization at six years. Infants' VRM, object permanence, and cross-modal transfer of perceptions at one year were related to their IQ and several outcomes at six years.…

  14. Validating dimensions of psychosis symptomatology: Neural correlates and 20-year outcomes.

    PubMed

    Kotov, Roman; Foti, Dan; Li, Kaiqiao; Bromet, Evelyn J; Hajcak, Greg; Ruggero, Camilo J

    2016-11-01

    Heterogeneity of psychosis presents significant challenges for classification. Between 2 and 12 symptom dimensions have been proposed, and consensus is lacking. The present study sought to identify uniquely informative models by comparing the validity of these alternatives. An epidemiologic cohort of 628 first-admission inpatients with psychosis was interviewed 6 times over 2 decades and completed an electrophysiological assessment of error processing at year 20. We first analyzed a comprehensive set of 49 symptoms rated by interviewers at baseline, progressively extracting from 1 to 12 factors. Next, we compared the ability of resulting factor solutions to (a) account for concurrent neural dysfunction and (b) predict 20-year role, social, residential, and global functioning, and life satisfaction. A four-factor model showed incremental validity with all outcomes, and more complex models did not improve explanatory power. The 4 dimensions-reality distortion, disorganization, inexpressivity, and apathy/asociality-were replicable in 5 follow-ups, internally consistent, stable across assessments, and showed strong discriminant validity. These results reaffirm the value of separating disorganization and reality distortion, are consistent with recent findings distinguishing inexpressivity and apathy/asociality, and suggest that these 4 dimensions are fundamental to understanding neural abnormalities and long-term outcomes in psychosis. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  15. Corrosion resistant neutron absorbing coatings

    DOEpatents

    Choi, Jor-Shan [El Cerrito, CA; Farmer, Joseph C [Tracy, CA; Lee, Chuck K [Hayward, CA; Walker, Jeffrey [Gaithersburg, MD; Russell, Paige [Las Vegas, NV; Kirkwood, Jon [Saint Leonard, MD; Yang, Nancy [Lafayette, CA; Champagne, Victor [Oxford, PA

    2012-05-29

    A method of forming a corrosion resistant neutron absorbing coating comprising the steps of spray or deposition or sputtering or welding processing to form a composite material made of a spray or deposition or sputtering or welding material, and a neutron absorbing material. Also a corrosion resistant neutron absorbing coating comprising a composite material made of a spray or deposition or sputtering or welding material, and a neutron absorbing material.

  16. Corrosion resistant neutron absorbing coatings

    DOEpatents

    Choi, Jor-Shan; Farmer, Joseph C; Lee, Chuck K; Walker, Jeffrey; Russell, Paige; Kirkwood, Jon; Yang, Nancy; Champagne, Victor

    2013-11-12

    A method of forming a corrosion resistant neutron absorbing coating comprising the steps of spray or deposition or sputtering or welding processing to form a composite material made of a spray or deposition or sputtering or welding material, and a neutron absorbing material. Also a corrosion resistant neutron absorbing coating comprising a composite material made of a spray or deposition or sputtering or welding material, and a neutron absorbing material.

  17. Clinical outcomes of redo valvular operations: a 20-year experience.

    PubMed

    Fukunaga, Naoto; Okada, Yukikatsu; Konishi, Yasunobu; Murashita, Takashi; Yuzaki, Mitsuru; Shomura, Yu; Fujiwara, Hiroshi; Koyama, Tadaaki

    2012-12-01

    A higher operative mortality rate has been reported after redo valvular procedures than after the primary operation. Outcomes of 330 consecutive patients undergoing 433 redo valvular operations at our institute during a 20-year period (January 1990 to December 2010) were reviewed retrospectively. The mean follow-up was 6.4 years (range, 0.05 to 1.3 years). Logistic regression analysis was used to identify factors associated with hospital death. The overall hospital mortality rate was 6.7% (29 of 433 procedures). Logistic regression analysis identified only advanced New York Heart Association (NYHA) class as an independent predictor of hospital death. Overall survival at 5, 10, and 15 years was 83.6%±2.2%, 70.7%±3.4%, and 61.5%±4.5%, respectively. The 5-, 10-, and 15-year survivals for the first redo vs more than second redo groups were 86.5%±2.4% vs 74.7%±5.5%, 71.8%±3.9% vs 66.8%±6.6%, and 60.2%±5.7% vs 63.1%±7.2%, respectively (log-rank P=0.505). The 5- and 10-year survivals for NYHA class I/II vs III/IV patients were 91.5%±2.1% vs 70.4%±4.5% and 77.8%±4.1% vs 58.5%±5.6%, respectively (log-rank p<0.005). Redo valvular operation in NYHA class III/IV patients is associated with high hospital death and poor long-term survival. To achieve low hospital death and good long-term survival, redo operations, including more than third redo operations, should be performed in patients with lower NYHA class. Copyright © 2012 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  18. Thermally induced nonlinear optical absorption in metamaterial perfect absorbers

    NASA Astrophysics Data System (ADS)

    Guddala, Sriram; Kumar, Raghwendra; Ramakrishna, S. Anantha

    2015-03-01

    A metamaterial perfect absorber consisting of a tri-layer (Al/ZnS/Al) metal-dielectric-metal system with top aluminium nano-disks was fabricated by laser-interference lithography and lift-off processing. The metamaterial absorber had peak resonant absorbance at 1090 nm and showed nonlinear absorption for 600ps laser pulses at 1064 nm wavelength. A nonlinear saturation of reflectance was measured to be dependent on the average laser power incident and not the peak laser intensity. The nonlinear behaviour is shown to arise from the heating due to the absorbed radiation and photo-thermal changes in the dielectric properties of aluminium. The metamaterial absorber is seen to be damage resistant at large laser intensities of 25 MW/cm2.

  19. Simulation, fabrication and characterization of THz metamaterial absorbers.

    PubMed

    Grant, James P; McCrindle, Iain J H; Cumming, David R S

    2012-12-27

    Metamaterials (MM), artificial materials engineered to have properties that may not be found in nature, have been widely explored since the first theoretical(1) and experimental demonstration(2) of their unique properties. MMs can provide a highly controllable electromagnetic response, and to date have been demonstrated in every technologically relevant spectral range including the optical(3), near IR(4), mid IR(5) , THz(6) , mm-wave(7) , microwave(8) and radio(9) bands. Applications include perfect lenses(10), sensors(11), telecommunications(12), invisibility cloaks(13) and filters(14,15). We have recently developed single band(16), dual band(17) and broadband(18) THz metamaterial absorber devices capable of greater than 80% absorption at the resonance peak. The concept of a MM absorber is especially important at THz frequencies where it is difficult to find strong frequency selective THz absorbers(19). In our MM absorber the THz radiation is absorbed in a thickness of ~ λ/20, overcoming the thickness limitation of traditional quarter wavelength absorbers. MM absorbers naturally lend themselves to THz detection applications, such as thermal sensors, and if integrated with suitable THz sources (e.g. QCLs), could lead to compact, highly sensitive, low cost, real time THz imaging systems.

  20. Evaluation of a commercially available passively Q-switched Nd:YAG laser with LiF: F2- saturable absorber for laser-induced breakdown spectroscopy

    NASA Astrophysics Data System (ADS)

    Carson, Cantwell G.; Goueguel, Christian L.; Sanghapi, Hervé; Jain, Jinesh; McIntyre, Dustin

    2016-05-01

    Interest in passively Q-switched microchip lasers as a means for miniaturization of laser-induced breakdown spectroscopy (LIBS) apparatus has rapidly grown in the last years. To explore the possibility of using a comparatively UV-vis transparent absorber, we herein present the first report on the evaluation of a commercially available flash lamp-pumped passively Q-switched Nd:YAG laser with LiF: F2- saturable absorber as an excitation source in LIBS. Quantitative measurements of barium, strontium, rubidium and lithium in granite, rhyolite, basalt and syenite whole-rock glass samples were performed. Using a gated intensified benchtop spectrometer, limits of detection of 0.97, 23, 37, and 144 ppm were obtained for Li, Sr, Rb, and Ba, respectively. Finally, we discuss the advantages of using such a laser unit for LIBS applications in terms of ablation efficiency, analytical performances, output energy, and standoff capabilities.

  1. Antisocial Behavioral Syndromes and Three-Year Quality of Life Outcomes in United States Adults

    PubMed Central

    Goldstein, Risë B.; Dawson, Deborah A.; Smith, Sharon M.; Grant, Bridget F.

    2013-01-01

    Objective To examine 3-year quality-of-life (QOL) outcomes among United States adults with Diagnostic and Statistical Manual of Mental Disorders – Fourth Edition (DSM-IV) antisocial personality disorder (ASPD), syndromal adult antisocial behavior without conduct disorder (CD) before age 15 (AABS, not a DSM-IV diagnosis), or no antisocial behavioral syndrome at baseline. Method Face-to-face interviews (n= 34,653). Psychiatric disorders were assessed using the Alcohol Use Disorder and Associated Disabilities Interview Schedule – DSM-IV Version. Health-related QOL was assessed using the Short-Form 12-Item Health Survey, version 2 (SF-12v2). Other outcomes included past-year Perceived Stress Scale-4 (PSS-4) scores, employment, receipt of Supplemental Security Income (SSI), welfare, and food stamps, and participation in social relationships. Results ASPD and AABS predicted poorer employment, financial dependency, social relationship, and physical health outcomes. Relationships of antisociality to SSI and food stamp receipt and physical health scales were modified by baseline age. Both antisocial syndromes predicted higher PSS-4, AABS predicted lower SF-12v2 Vitality, and ASPD predicted lower SF-12v2 Social Functioning scores in women. Conclusion Similar prediction of QOL by ASPD and AABS suggests limited utility of requiring CD before age 15 to diagnose ASPD. Findings underscore the need to improve prevention and treatment of antisocial syndromes. PMID:22375904

  2. Intensity tunable infrared broadband absorbers based on VO2 phase transition using planar layered thin films

    PubMed Central

    Kocer, Hasan; Butun, Serkan; Palacios, Edgar; Liu, Zizhuo; Tongay, Sefaattin; Fu, Deyi; Wang, Kevin; Wu, Junqiao; Aydin, Koray

    2015-01-01

    Plasmonic and metamaterial based nano/micro-structured materials enable spectrally selective resonant absorption, where the resonant bandwidth and absorption intensity can be engineered by controlling the size and geometry of nanostructures. Here, we demonstrate a simple, lithography-free approach for obtaining a resonant and dynamically tunable broadband absorber based on vanadium dioxide (VO2) phase transition. Using planar layered thin film structures, where top layer is chosen to be an ultrathin (20 nm) VO2 film, we demonstrate broadband IR light absorption tuning (from ~90% to ~30% in measured absorption) over the entire mid-wavelength infrared spectrum. Our numerical and experimental results indicate that the bandwidth of the absorption bands can be controlled by changing the dielectric spacer layer thickness. Broadband tunable absorbers can find applications in absorption filters, thermal emitters, thermophotovoltaics and sensing. PMID:26294085

  3. Outcomes at 7 years for babies who developed neonatal necrotising enterocolitis: the ORACLE Children Study.

    PubMed

    Pike, Katie; Brocklehurst, Peter; Jones, David; Kenyon, Sarah; Salt, Alison; Taylor, David; Marlow, Neil

    2012-09-01

    Within the ORACLE Children Study Cohort, the authors have evaluated long-term consequences of the diagnosis of confirmed or suspected neonatal necrotising enterocolitis (NEC) at age of 7 years. Outcomes were assessed using a parental questionnaire, including the Health Utilities Index (HUI-3) to assess functional impairment, and specific medical and behavioural outcomes. Educational outcomes for children in England were explored using national standardised tests. Multiple logistic regression was used to explore independent associates of NEC within the cohort. The authors obtained data for 119 (77%) of 157 children following proven or suspected NEC and compared their outcomes with those of the remaining 6496 children. NEC was associated with an increase in risk of neonatal death (OR 14.6 (95% CI 10.4 to 20.6)). At 7 years, NEC conferred an increased risk of all grades of impairment. Adjusting for confounders, risks persisted for any HUI-3 defined functional impairment (adjusted OR 1.55 (1.05, 2.29)), particularly mild impairment (adjusted OR 1.61 (1.03, 2.53)) both in all NEC children and in those with proven NEC, which appeared to be independent. No behavioural or educational associations were confirmed. Following NEC, children were more likely to suffer bowel problems than non-NEC children (adjusted OR 3.96 (2.06, 7.61)). The ORACLE Children Study provided opportunity for the largest evaluation of school age outcome following neonatal NEC and demonstrates significant long-term consequences of both gut function (presence of stoma, admission for bowel problems and continuing medical care for gut-related problems) and motor, sensory and cognitive outcomes as measured using HUI-3.

  4. The predictive effect of insight on adverse clinical outcomes in bipolar I disorder: a two-year prospective study.

    PubMed

    Yen, Cheng-Fang; Chen, Cheng-Sheng; Yen, Ju-Yu; Ko, Chih-Hung

    2008-05-01

    Research has revealed that a lack of insight is associated with poorer clinical outcomes in schizophrenia; however, the predictive value of insight on adverse clinical outcomes among bipolar patients is quite understudied. The aim of this prospective study was to examine the impact of insight on adverse clinical outcomes among the patients with bipolar I disorder over a 2-year period. Sixty-five remitted bipolar I disorder patients received follow-up assessments at 3, 6, 9, 12, 18, and 24 months to detect the adverse clinical outcomes defined by the incidence of bipolar-related psychiatric hospitalization, emergency room visits, violent or suicidal behavior. The Schedule of Assessment of Insight was used to provide a baseline insight score. Cox regression analysis was used to examine the predictive value of insight on the adverse clinical outcomes. Impaired insight into treatment and a greater number of previous hospitalizations significantly increased the risk of adverse clinical outcomes with bipolar disorder in the 2-year period. However, insight into recognition of the illness and re-labeling of psychotic phenomena did not have any significant effect on adverse clinical outcomes. Bipolar patients' insight into treatment is an independent predictor of adverse clinical outcomes. Improving insight into treatment might be a promising target for a better outcome.

  5. 10-Year Outcomes after Monitoring, Surgery, or Radiotherapy for Localized Prostate Cancer.

    PubMed

    Hamdy, Freddie C; Donovan, Jenny L; Lane, J Athene; Mason, Malcolm; Metcalfe, Chris; Holding, Peter; Davis, Michael; Peters, Tim J; Turner, Emma L; Martin, Richard M; Oxley, Jon; Robinson, Mary; Staffurth, John; Walsh, Eleanor; Bollina, Prasad; Catto, James; Doble, Andrew; Doherty, Alan; Gillatt, David; Kockelbergh, Roger; Kynaston, Howard; Paul, Alan; Powell, Philip; Prescott, Stephen; Rosario, Derek J; Rowe, Edward; Neal, David E

    2016-10-13

    The comparative effectiveness of treatments for prostate cancer that is detected by prostate-specific antigen (PSA) testing remains uncertain. We compared active monitoring, radical prostatectomy, and external-beam radiotherapy for the treatment of clinically localized prostate cancer. Between 1999 and 2009, a total of 82,429 men 50 to 69 years of age received a PSA test; 2664 received a diagnosis of localized prostate cancer, and 1643 agreed to undergo randomization to active monitoring (545 men), surgery (553), or radiotherapy (545). The primary outcome was prostate-cancer mortality at a median of 10 years of follow-up. Secondary outcomes included the rates of disease progression, metastases, and all-cause deaths. There were 17 prostate-cancer-specific deaths overall: 8 in the active-monitoring group (1.5 deaths per 1000 person-years; 95% confidence interval [CI], 0.7 to 3.0), 5 in the surgery group (0.9 per 1000 person-years; 95% CI, 0.4 to 2.2), and 4 in the radiotherapy group (0.7 per 1000 person-years; 95% CI, 0.3 to 2.0); the difference among the groups was not significant (P=0.48 for the overall comparison). In addition, no significant difference was seen among the groups in the number of deaths from any cause (169 deaths overall; P=0.87 for the comparison among the three groups). Metastases developed in more men in the active-monitoring group (33 men; 6.3 events per 1000 person-years; 95% CI, 4.5 to 8.8) than in the surgery group (13 men; 2.4 per 1000 person-years; 95% CI, 1.4 to 4.2) or the radiotherapy group (16 men; 3.0 per 1000 person-years; 95% CI, 1.9 to 4.9) (P=0.004 for the overall comparison). Higher rates of disease progression were seen in the active-monitoring group (112 men; 22.9 events per 1000 person-years; 95% CI, 19.0 to 27.5) than in the surgery group (46 men; 8.9 events per 1000 person-years; 95% CI, 6.7 to 11.9) or the radiotherapy group (46 men; 9.0 events per 1000 person-years; 95% CI, 6.7 to 12.0) (P<0.001 for the overall comparison

  6. Three-Year Outcomes of Surgical Versus Endovascular Revascularization for Critical Limb Ischemia

    PubMed Central

    Takahara, Mitsuyoshi; Soga, Yoshimitsu; Kodama, Akio; Terashi, Hiroto; Azuma, Nobuyoshi

    2017-01-01

    Background— The aim of this study was to compare clinical outcomes between surgical reconstruction and endovascular therapy (EVT) for critical limb ischemia (CLI) in today’s real-world settings. Methods and Results— This multicenter, prospective, observational study registered and followed 548 Japanese CLI patients. The registration was in advance of revascularization; 197 patients were scheduled to receive surgical reconstruction, and the remaining 351 were scheduled to receive EVT. The primary end point was 3-year amputation-free survival, compared between the 2 treatments in an intention-to-treat manner, using propensity score matching. Interaction analysis was additionally performed to explore which subgroups had better outcomes with surgical reconstruction or EVT. After propensity score matching, the 3-year amputation-free survival was not significantly different between the 2 groups (52% [95% confidence interval, 43%–60%] and 52% [95% confidence interval, 44–60%]; P=0.26). Subsequent interaction analysis identified (1) Wound, Ischemia, and foot Infection (WIfI) classification W-3, (2) fI-2/3, (3) history of ipsilateral minor amputation, (4) history of revascularization after CLI onset, and (5) bilateral CLI as the factors more favorable for surgical reconstruction, whereas (1) diabetes mellitus, (2) renal failure, (3) anemia, (4) history of nonadherence to cardiovascular risk management, and (5) contralateral major amputation were as those less favorable for surgical reconstruction. Conclusions— The 3-year amputation-free survival was not different between surgical reconstruction and EVT in the overall CLI population. The subsequent interaction analysis suggested that there would be a subgroup more suited for surgical reconstruction and another benefiting more from EVT. Clinical Trial Registration— URL: http://www.umin.ac.jp/ctr/. Unique identifier: UMIN000007050. PMID:29246911

  7. Use of a novel fractional CO2 laser for the treatment of genitourinary syndrome of menopause: 1-year outcomes.

    PubMed

    Sokol, Eric R; Karram, Mickey M

    2017-07-01

    To assess safety and efficacy of a fractional CO2 laser therapy for the treatment of genitourinary syndrome of menopause (GSM) with follow-up to 1 year posttreatment. Women presenting with GSM and meeting inclusion criterion were enrolled. Visual Analog Scales were used to grade vaginal pain, burning, itching, dryness, dyspareunia, and dysuria. Dilators were used to rate vaginal elasticity at baseline and at each follow-up visit. Before each treatment and at follow-up, Vaginal Health Index scoring and Female Sexual Function Index questionnaires were completed. Women received three vaginal laser treatments spaced 6 weeks apart. Participant satisfaction was measured on 5-point Likert scales (1 = very dissatisfied, 5 = very satisfied). Of 30 women (mean age 58.6 ± 8.8 years), three were lost to follow-up at 3 months and six at 1 year. None were discontinued or withdrew due to an adverse event. Average improvement in Visual Analog Scale scores for all symptom categories was statistically significant at 3 months and remained so through 1 year, except dysuria. Differences between data at 3 months and 1 year were not statistically significant, indicating persistence of positive outcomes. Average overall improvement in pain was 1.9 (±3.4), burning 1.9 (±3.1), itching 1.4 (±1.9), dryness 5.9 (±2.8), dyspareunia 4.9 (±3.3), and dysuria 0.9 (±3.1). Improvement in average Vaginal Health Index and Female Sexual Function Index scores was also statistically significant (P < 0.0001). Of 19 women undergoing dilator examination at 1 year, 18 (94.8%) were comfortable with the same or larger dilator size. Twenty-two of 24 women (92%) were satisfied or extremely satisfied with the treatment at 1 year. Based on study data up to 1 year, the fractional CO2 laser may be an effective and safe treatment for women suffering from symptoms of GSM, although additional studies with larger populations and placebo control is needed to confirm these results.

  8. Counterflow absorber for an absorption refrigeration system

    DOEpatents

    Reimann, Robert C.

    1984-01-01

    An air-cooled, vertical tube absorber for an absorption refrigeration system is disclosed. Strong absorbent solution is supplied to the top of the absorber and refrigerant vapor is supplied to the bottom of the absorber to create a direct counterflow of refrigerant vapor and absorbent solution in the absorber. The refrigeration system is designed so that the volume flow rate of refrigerant vapor in the tubes of the absorber is sufficient to create a substantially direct counterflow along the entire length of each tube in the absorber. This provides several advantages for the absorber such as higher efficiency and improved heat transfer characteristics, and allows improved purging of non-condensibles from the absorber.

  9. Measurements of Light Absorbing Particles on Tropical South American Glaciers

    NASA Astrophysics Data System (ADS)

    Schmitt, C. G.; All, J.; Schwarz, J. P.; Arnott, W. P.; Warthon, J.; Andrade, M.; Celestian, A. J.; Hoffmann, D.; Cole, R. J.; Lapham, E.; Horodyskyj, U. N.; Froyd, K. D.; Liao, J.

    2014-12-01

    Glaciers in the tropical Andes have been losing mass rapidly in recent decades. In addition to the documented increase in temperature, increases in light absorbing particulates deposited on glaciers could be contributing to the observed glacier loss. Here we present results of measurements of light absorbing particles from glaciers in Peru and Bolivia. Samples have been collected by American Climber Science Program volunteers and scientists at altitudes up to 6770 meters. Collected snow samples were melted and filtered in the field. A new inexpensive technique, the Light Absorption Heating Method (LAHM) has been developed for analysis of light absorbing particles collected on filters. Results from LAHM analysis are calibrated using filters with known amounts of fullerene soot, a common industrial surrogate for black carbon (BC). For snow samples collected at the same field location LAHM analysis and measurements from the Single Particle Soot Photometer (SP2) instrument are well correlated (r2 = 0.92). Co-located SP2 and LAHM filter analysis suggest that BC could be the dominant absorbing component of the light absorbing particles in some areas.

  10. Comparison of bone healing and outcomes between allogenous bone chip and hydroxyapatite chip grafts in open wedge high tibial osteotomy.

    PubMed

    Lee, O-Sung; Lee, Kyung Jae; Lee, Yong Seuk

    2017-11-03

    Allogenous bone chips and hydroxyapatite (HA) chips have been known as good options for filling an inevitable void after open wedge high tibial osteotomy (OWHTO). However, there are concerns regarding bone healing after the use of these grafts. The purpose of this study was to compare the bone healing represented by the osteoconductivity and absorbability between allogenous bone chips and HA chips in OWHTO. The outcomes of bone healing of 53 patients who received an allogenous bone chip graft and 41 patients who received an HA chip graft were retrospectively evaluated, and the results were compared between the two groups. Osteoconductivity and absorbability were serially evaluated for the assessment of bone healing at 6 weeks, 3 months, 6 months, and 1 year postoperatively. The osteoconductivity of the allogenous bone chips was greater than that of the HA chips at 6 weeks postoperatively (p < 0.05). However, there were no statistically significant differences from 3 months to 1 year postoperatively. The absorbability showed no statistically significant differences 6 weeks and 3 months after OWHTO; however, the allogenous bone chip group showed a greater absorbability at 6 months and 1 year postoperatively (42.8 ± 14.2 vs. 34.6 ± 13.8, p = 0.006 at 6 months postoperatively; 54.6 ± 14.4 vs. 43.0 ± 14.0, p < 0.001 at 1 year postoperatively). However, the two graft materials showed similar results of HKA angle, WBL ratio, posterior tibial slope.

  11. Fabrication of Cu2ZnSn(S,Se)4 (CZTSSe) absorber films based on solid-phase synthesis and blade coating processes

    NASA Astrophysics Data System (ADS)

    Ma, Ruixin; Yang, Fan; Li, Shina; Zhang, Xiaoyong; Li, Xiang; Cheng, Shiyao; Liu, Zilin

    2016-04-01

    CZTSSe is an important earth abundant collection of materials for the development of low cost and high efficiency thin film solar cells. This work developed a simple non-vacuum-based route to fabricate CZTSSe absorber films. This was demonstrated by first synthesizing Cu2ZnSnS4 (CZTS) nano-crystalline based on solid-phase synthesis. Then a stable colloidal ink composed of CZTS nano-crystalline was blade coated on Mo-coated substrates followed by an annealing process under Ar atmosphere. After CZTS films formation, the films were sintered into CZTSSe absorber films by exposing them under Selenium vapor. The formation of a kesterite type CZTS was confirmed using X-ray diffraction and Raman scattering measurements. The band gap of CZTSSe absorber films was determined to be 1.26 eV, which was appropriate for use as an absorber layer in thin film solar cells. The CZTSSe absorber films showed a good photovoltatic performance, demonstrating this simple approach had great potential for CZTSSe solar cell production.

  12. Assessing the long-term outcomes of minor lower limb amputations: a 5-year study.

    PubMed

    Uzzaman, Mohammed Mohsin; Jukaku, Saud; Kambal, Amir; Hussain, Syed Tahir

    2011-07-01

    Our aim was to assess the long-term outcome for minor forefoot amputations. A retrospective study of 126 patients who had such amputations between 1999 and 2004 was performed. Patients were divided into 2 groups, diabetic (group A: 79 patients) and nondiabetic (group B: 47 patients). Angiograms were requested in 45 patients in group A compared with 31 patients in group B (P = ·77). In group A, 11 patients underwent further ipsilateral amputations compared with 30 patients in group B (P = ·02.). The 2 groups were equally likely to have vascular reconstruction (35% vs 37%). The overall 5-year mortality was 27%, with 58% of deaths occurring within the first year. This study shows that foot amputees have high mortality and reintervention rates. Adequate utilization of vascular services, extra vigilance in the prevention of complications, and risk factor modifications are required to improve postoperative outcomes.

  13. Marijuana use trajectories during college predict health outcomes nine years post-matriculation

    PubMed Central

    Arria, Amelia M.; Caldeira, Kimberly M.; Bugbee, Brittany A.; Vincent, Kathryn B.; O’Grady, Kevin E.

    2015-01-01

    Background Several studies have linked marijuana use with a variety of health outcomes among young adults. Information about marijuana’s long-term health effects is critically needed. Methods Data are from a ten-year study of 1,253 young adults originally recruited as first-year college students and assessed annually thereafter. Six trajectories of marijuana use during college (Non-Use, Low-Stable, Early-Decline, College-Peak, Late-Increase, Chronic) were previously derived using latent variable growth mixture modeling. Nine health outcomes assessed in Year 10 (modal age 27) were regressed on a group membership variable for the six group trajectories, holding constant demographics, baseline health status, and alcohol and tobacco trajectory group membership. Results Marijuana trajectory groups differed significantly on seven of the nine outcomes (functional impairment due to injury, illness, or emotional problems; psychological distress; subjective well-being; and mental and physical health service utilization; all ps<.001), but not on general health rating or body mass index. Non-Users fared better than the Late-Increase and Chronic groups on most physical and mental health outcomes. The declining groups (Early-Decline, College-Peak) fared better than the Chronic group on mental health outcomes. The Late-Increase group fared significantly worse than the stable groups (Non-Use, Low-Stable, Chronic) on both physical and mental health outcomes. Conclusions Even occasional or time-limited marijuana use might have adverse effects on physical and mental health, perhaps enduring after several years of moderation or abstinence. Reducing marijuana use frequency might mitigate such effects. Individuals who escalate their marijuana use in their early twenties might be at especially high risk for adverse outcomes. PMID:26778758

  14. Clinical and radiographic assessment of various predictors for healing outcome 1 year after periapical surgery.

    PubMed

    von Arx, Thomas; Jensen, Simon Storgård; Hänni, Stefan

    2007-02-01

    This clinical study prospectively evaluated the influence of various predictors on healing outcome 1 year after periapical surgery. The study cohort included 194 teeth in an equal number of patients. Three teeth were lost for the follow-up (1.5% drop-out rate). Clinical and radiographic measures were used to determine the healing outcome. For statistical analysis, results were dichotomized (healed versus nonhealed). The overall success rate was 83.8% (healed cases). The only individual predictors to prove significant for the outcome were pain at initial examination (p=0.030) and other clinical signs or symptoms at initial examination (p=0.042), meaning that such teeth had lower healing rates 1 year after periapical surgery compared with teeth without such signs or symptoms. Logistic regression revealed that pain at initial examination (odds ratio=2.59, confidence interval=1.2-5.6, p=0.04) was the only predictor reaching significance. Several predictors almost reached statistical significance: lesion size (p=0.06), retrofilling material (p=0.06), and postoperative healing course (p=0.06).

  15. Performance of chemical vapor deposition fabricated graphene absorber mirror in Yb3+ : Sc2SiO5 mode-locked laser

    NASA Astrophysics Data System (ADS)

    Cai, Wei; Li, Yaqi; Zhu, Hongtong; Jiang, Shouzhen; Xu, Shicai; Liu, Jie; Zheng, Lihe; Su, Liangbi; Xu, Jun

    2014-12-01

    A reflective graphene saturable absorber mirror (SAM) was successfully fabricated by chemical vapor deposition technology. A stable diode-pumped passively mode-locked Yb3+:Sc2SiO5 laser using a graphene SAM as a saturable absorber was accomplished for the first time. The measured average output power amounts to 351 mW under the absorbed pump power of 12.5 W. Without prisms compensating for dispersion, the minimum pulse duration of 7 ps with a repetition rate of 97 MHz has been obtained at the central wavelength of 1063 nm. The corresponding peak power and the maximum pulse energy were 516 W and 3.6 nJ, respectively.

  16. Cu-In Halide Perovskite Solar Absorbers.

    PubMed

    Zhao, Xin-Gang; Yang, Dongwen; Sun, Yuanhui; Li, Tianshu; Zhang, Lijun; Yu, Liping; Zunger, Alex

    2017-05-17

    The long-term chemical instability and the presence of toxic Pb in otherwise stellar solar absorber APbX 3 made of organic molecules on the A site and halogens for X have hindered their large-scale commercialization. Previously explored ways to achieve Pb-free halide perovskites involved replacing Pb 2+ with other similar M 2+ cations in ns 2 electron configuration, e.g., Sn 2+ or by Bi 3+ (plus Ag + ), but unfortunately this showed either poor stability (M = Sn) or weakly absorbing oversized indirect gaps (M = Bi), prompting concerns that perhaps stability and good optoelectronic properties might be contraindicated. Herein, we exploit the electronic structure underpinning of classic Cu[In,Ga]Se 2 (CIGS) chalcopyrite solar absorbers to design Pb-free halide perovskites by transmuting 2Pb to the pair [B IB + C III ] such as [Cu + Ga] or [Ag + In] and combinations thereof. The resulting group of double perovskites with formula A 2 BCX 6 (A = K, Rb, Cs; B = Cu, Ag; C = Ga, In; X = Cl, Br, I) benefits from the ionic, yet narrow-gap character of halide perovskites, and at the same time borrows the advantage of the strong Cu(d)/Se(p) → Ga/In(s/p) valence-to-conduction-band absorption spectra known from CIGS. This constitutes a new group of CuIn-based Halide Perovskite (CIHP). Our first-principles calculations guided by such design principles indicate that the CIHPs class has members with clear thermodynamic stability, showing direct band gaps, and manifesting a wide-range of tunable gap values (from zero to about 2.5 eV) and combination of light electron and heavy-light hole effective masses. Materials screening of candidate CIHPs then identifies the best-of-class Rb 2 [CuIn]Cl 6 , Rb 2 [AgIn]Br 6 , and Cs 2 [AgIn]Br 6 , having direct band gaps of 1.36, 1.46, and 1.50 eV, and theoretical spectroscopic limited maximal efficiency comparable to chalcopyrites and CH 3 NH 3 PbI 3 . Our finding offers a new routine for designing new-type Pb-free halide perovskite solar

  17. Self-Regulating Shock Absorber

    NASA Technical Reports Server (NTRS)

    Wesselski, Clarence J.

    1995-01-01

    Mechanical shock absorber keeps frictional damping force within tolerable limit. Its damping force does not increase with coefficient of friction between energy-absorbing components; rather, frictional damping force varies only slightly. Relatively insensitive to manufacturing variations and environmental conditions altering friction. Does not exhibit high breakaway friction and consequent sharp increase followed by sharp decrease in damping force at beginning of stroking. Damping force in absorber does not vary appreciably with speed of stroking. In addition, not vulnerable to leakage of hydraulic fluid.

  18. Five-Year Outcomes from 3 Prospective Trials of Image-Guided Proton Therapy for Prostate Cancer

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Mendenhall, Nancy P., E-mail: menden@shands.ufl.edu; Hoppe, Bradford S.; Nichols, Romaine C.

    2014-03-01

    Purpose: To report 5-year clinical outcomes of 3 prospective trials of image-guided proton therapy for prostate cancer. Methods and Materials: A total of 211 prostate cancer patients (89 low-risk, 82 intermediate-risk, and 40 high-risk) were treated in institutional review board-approved trials of 78 cobalt gray equivalent (CGE) in 39 fractions for low-risk disease, 78 to 82 CGE for intermediate-risk disease, and 78 CGE with concomitant docetaxel therapy followed by androgen deprivation therapy for high-risk disease. Toxicities were graded according to Common Terminology Criteria for Adverse Events (CTCAE), version 3.0. Median follow-up was 5.2 years. Results: Five-year rates of biochemical and clinicalmore » freedom from disease progression were 99%, 99%, and 76% in low-, intermediate-, and high-risk patients, respectively. Actuarial 5-year rates of late CTCAE, version 3.0 (or version 4.0) grade 3 gastrointestinal and urologic toxicity were 1.0% (0.5%) and 5.4% (1.0%), respectively. Median pretreatment scores and International Prostate Symptom Scores at >4 years posttreatment were 8 and 7, 6 and 6, and 9 and 8, respectively, among the low-, intermediate-, and high-risk patients. There were no significant changes between median pretreatment summary scores and Expanded Prostate Cancer Index Composite scores at >4 years for bowel, urinary irritative and/or obstructive, and urinary continence. Conclusions: Five-year clinical outcomes with image-guided proton therapy included extremely high efficacy, minimal physician-assessed toxicity, and excellent patient-reported outcomes. Further follow-up and a larger patient experience are necessary to confirm these favorable outcomes.« less

  19. Rehabilitation outcomes in children with cerebral palsy during a 2 year period

    PubMed Central

    İçağasıoğlu, Afitap; Mesci, Erkan; Yumusakhuylu, Yasemin; Turgut, Selin Turan; Murat, Sadiye

    2015-01-01

    [Purpose] To observe motor and functional progress of children with cerebral palsy during 2years. [Subjects and Methods] Pediatric cerebral palsy patients aged 3–15 years (n = 35/69) with 24-month follow-up at our outpatient cerebral palsy clinic were evaluated retrospectively. The distribution of cerebral palsy types was as follows: diplegia (n = 19), hemiplegia (n = 4), and quadriplegia (n = 12). Participants were divided into 3 groups according to their Gross Motor Functional Classification System scores (i.e., mild, moderate, and severe). All participants were evaluated initially and at the final assessment 2years later. During this time, patients were treated 3 times/week. Changes in motor and functional abilities were assessed based on Gross Motor Function Measure-88 and Wee Functional Independence Measure. [Results] Significant improvements were observed in Gross Motor Function Measure-88 and Wee Functional Independence Measure results in all 35 patients at the end of 2years. The Gross Motor Function Measure-88 scores correlated with Wee Functional Independence Measure Scores. Marked increases in motor and functional capabilities in mild and moderate cerebral palsy patients were observed in the subgroup assessments, but not in those with severe cerebral palsy. [Conclusion] Rehabilitation may greatly help mild and moderate cerebral palsy patients achieve their full potential. PMID:26644677

  20. Freeze-Dried Carbon Nanotube Aerogels for High-Frequency Absorber Applications.

    PubMed

    Anoshkin, Ilya V; Campion, James; Lioubtchenko, Dmitri V; Oberhammer, Joachim

    2018-06-13

    A novel technique for millimeter wave absorber material embedded in a metal waveguide is proposed. The absorber material is a highly porous carbon nanotube (CNT) aerogel prepared by a freeze-drying technique. CNT aerogel structures are shown to be good absorbers with a low reflection coefficient, less than -12 dB at 95 GHz. The reflection coefficient of the novel absorber is 3-4 times lower than that of commercial absorbers with identical geometry. Samples prepared by freeze-drying at -25 °C demonstrate resonance behavior, while those prepared at liquid nitrogen temperature (-196 °C) exhibit a significant decrease in reflection coefficient, with no resonant behavior. CNT absorbers of identical volume based on wet-phase drying preparation show significantly worse performance than the CNT aerogel absorbers prepared by freeze-drying. Treatment of the freeze-dried CNT aerogel with n- and p-dopants (monoethanolamine and iodine vapors, respectively) shows remarkable improvement in the performance of the waveguide embedded absorbers, reducing the reflection coefficient by 2 dB across the band.

  1. Outcomes one year after a road accident: Results from the ESPARR cohort.

    PubMed

    Hours, Martine; Chossegros, Laetitia; Charnay, Pierrette; Tardy, Hélène; Nhac-Vu, Hoang-Thy; Boisson, Dominique; Luauté, Jacques; Laumon, Bernard

    2013-01-01

    Reducing the rates of death, trauma and sequelae associated with road accidents is the prime goal of road safety authorities, and success requires having data on victims' outcomes in the long term. The present study examined the outcome of adult road accident victims one year after their accident. A follow-up study. The cohort comprised 886 injured road-accident victims, aged ≥16 years, and living in the Rhône administrative Département, France (taken from the ESPARR Cohort). Data were collected on victim characteristics at the time of crash, and self-reported outcomes one year later. The population of respondents at the one-year questionnaire follow-up was divided into two categories according to injury severity, as mild-to-moderate (M.AIS<3) or severe (M.AIS 3+). Qualitative variables were compared between these 2 groups using Chi(2) or Fisher exact tests. At one year post-accident, 45% of the mild-to-moderate injury group versus only 20% of severely injured subjects reported full recovery of health (p<0.001). 20% of the cohort, as a whole, reported permanent pain. More than half of the severely injured subjects reported that the accident had had an impact on the everyday life of their family; this was twice as many as in the mild-to-moderate injury group (55% vs. 22%). Most of the severely injured reported impact on leisure, projects and emotional life: 20% reported relational difficulties in the couple, 16% reported impaired sexual life, and the rate of separation was significantly higher than in the mild-to-moderate injury group (5% vs. 1%; p<0.001). Mean time off work was significantly longer in the severe injury group: 245±158 days vs. 75±104 days (p<0.001); and 32% of the severe injury group (p<0.001) who had stopped work had not returned at 1 year, compared to 5% of the mild-to-moderate injury group. One year after a road accident, the consequences for victims remain significant. In terms of physical impact, pain frequently persists, impairing daily

  2. Mechanical energy absorber

    NASA Technical Reports Server (NTRS)

    Wesselski, Clarence J. (Inventor)

    1993-01-01

    An energy absorbing system for controlling the force where a moving object engages a stationary stop and where the system utilized telescopic tubular members, energy absorbing diaphragm elements, force regulating disc springs, and a return spring to return the telescoping member to its start position after stroking is presented. The energy absorbing system has frusto-conical diaphragm elements frictionally engaging the shaft and are opposed by a force regulating set of disc springs. In principle, this force feedback mechanism serves to keep the stroking load at a reasonable level even if the friction coefficient increases greatly. This force feedback device also serves to desensitize the singular and combined effects of manufacturing tolerances, sliding surface wear, temperature changes, dynamic effects, and lubricity.

  3. Laparoscopic Sleeve Gastrectomy Outcomes of 750 Patients: A 2.5-Year Experience at a Bariatric Center of Excellence.

    PubMed

    Altun, Hasan; Batman, Burcin; Uymaz, Salim D; Serin, Rahmi K; Salman, Serpil; Tayyareci, Yelda; Ece, Ferah; Hurkal, Tugce; Dal, Didem

    2016-12-01

    Laparoscopic sleeve gastrectomy (LSG) is gaining popularity worldwide. This retrospective cohort study evaluated the outcomes of a large cohort of patients with obesity who underwent LSG in a Bariatric Center of Excellence. All consecutive patients who underwent LSG between July 2013 and April 2016 were identified retrospectively. Preoperative and postoperative variables and comorbidities were recorded. The study consisted of 750 patients. Their mean age was 37.4 years; 72% were women, and the mean body mass index was 42.8 kg/m. The most common preoperative comorbidities were diabetes (23.3%), hyperlipidemia (21.9%), hypertension (21.1%), and obstructive sleep apnea (21.1%). The rates of comorbidity resolution during follow-up were 80.6%, 74.4%, 82.9%, and 94.3%, respectively. The percentage average excess weight loss 1, 3, and 6 months and 1 and 2 years after surgery was 29.4%±11.3%, 54.4%±17.7%, 76.9%±20.9%, 85.5%±23.6%, and 89.7%±27.6%, respectively. There was no mortality. LSG effectively and safely induced weight loss and comorbidity resolution.

  4. Associated lumbar scoliosis does not affect outcomes in patients undergoing focal minimally invasive surgery-transforaminal lumbar interbody fusion (MISTLIF) for neurogenic symptoms-a minimum 2-year follow-up study.

    PubMed

    Tay, Kae Sian; Bassi, Anupreet; Yeo, William; Yue, Wai Mun

    2017-01-01

    There is no current literature comparing outcomes of patients with and without lumbar scoliosis having neurologic symptoms undergoing minimally invasive surgery-transforaminal lumbar interbody fusion (MISTLIF) technique. This study aimed to determine whether associated lumbar scoliosis will result in different clinical, radiological, and operative outcomes in patients undergoing focal MISTLIF for neurogenic symptoms, without specific correction of the scoliosis. A retrospective case comparison study from prospectively collected hospital registry data was carried out. Two hundred and thirty eligible patients were evaluated and divided into two groups: Scoliosis Group (SG; n=57) with Cobb angle >10 degrees on anterioposterior (AP) plain lumbar spine radiographs and Non-Scoliosis Group (NSG; n=173) consisting of the remaining patients. Clinical outcomes were assessed using the Oswestry Disability Index, the North American Spine Society (NASS) Neurogenic Symptom Score, the NASS Satisfaction with Surgery Rating, the 36-Item Short-Form Health Survey (SF-36), and the Numerical Pain Rating Scale for back and leg pain. Radiological findings included Cobb angle, fusion, implant failure or loosening, and adjacent segment degeneration (ASD). Both groups were compared for demographics, perioperative parameters, complications, clinical, and radiological outcomes. Interobserver agreement (kappa statistics) for measurement of Cobb angle was calculated on all cases of both groups by two authors. Patients were evaluated preoperatively, at 6 months, and 2 years after surgery. The average follow-up was 2.88±1.47 years in the SG and 2.71±1.34 years in the NSG (p=.444). Differences in mean age (SG: 62.9±10.9 years and NSG: 57.6±13.1 years), estimated related risk of death (SG: 3.05±2.13 and NSG: 2.41±1.74), and gender (female=SG: 87.7% and NSG: 64.2%) were statistically significant (p<.05), whereas race distribution, body mass index |(BMI), spinal levels operated, number of levels

  5. Single-row, double-row, and transosseous equivalent techniques for isolated supraspinatus tendon tears with minimal atrophy: A retrospective comparative outcome and radiographic analysis at minimum 2-year followup

    PubMed Central

    McCormick, Frank; Gupta, Anil; Bruce, Ben; Harris, Josh; Abrams, Geoff; Wilson, Hillary; Hussey, Kristen; Cole, Brian J.

    2014-01-01

    Purpose: The purpose of this study was to measure and compare the subjective, objective, and radiographic healing outcomes of single-row (SR), double-row (DR), and transosseous equivalent (TOE) suture techniques for arthroscopic rotator cuff repair. Materials and Methods: A retrospective comparative analysis of arthroscopic rotator cuff repairs by one surgeon from 2004 to 2010 at minimum 2-year followup was performed. Cohorts were matched for age, sex, and tear size. Subjective outcome variables included ASES, Constant, SST, UCLA, and SF-12 scores. Objective outcome variables included strength, active range of motion (ROM). Radiographic healing was assessed by magnetic resonance imaging (MRI). Statistical analysis was performed using analysis of variance (ANOVA), Mann — Whitney and Kruskal — Wallis tests with significance, and the Fisher exact probability test <0.05. Results: Sixty-three patients completed the study requirements (20 SR, 21 DR, 22 TOE). There was a clinically and statistically significant improvement in outcomes with all repair techniques (ASES mean improvement P = <0.0001). The mean final ASES scores were: SR 83; (SD 21.4); DR 87 (SD 18.2); TOE 87 (SD 13.2); (P = 0.73). There was a statistically significant improvement in strength for each repair technique (P < 0.001). There was no significant difference between techniques across all secondary outcome assessments: ASES improvement, Constant, SST, UCLA, SF-12, ROM, Strength, and MRI re-tear rates. There was a decrease in re-tear rates from single row (22%) to double-row (18%) to transosseous equivalent (11%); however, this difference was not statistically significant (P = 0.6). Conclusions: Compared to preoperatively, arthroscopic rotator cuff repair, using SR, DR, or TOE techniques, yielded a clinically and statistically significant improvement in subjective and objective outcomes at a minimum 2-year follow-up. Level of Evidence: Therapeutic level 3. PMID:24926159

  6. Midwavelength interband cascade infrared photodetectors with superlattice absorbers and gain

    NASA Astrophysics Data System (ADS)

    Lei, Lin; Li, Lu; Lotfi, Hossein; Ye, Hao; Yang, Rui Q.; Mishima, Tetsuya D.; Santos, Michael B.; Johnson, Matthew B.

    2018-01-01

    We report on a comparison study of the electrical and optical properties of a set of device structures with different numbers of cascade stages, type-II superlattice (T2SL) absorber thickness, and doping variations, as well as a noncurrent-matched interband cascade infrared photodetectors (ICIP) structure with equal absorbers. Multistage ICIPs were demonstrated to be capable of operating at high temperatures at zero-bias with superior carrier transport over comparable conventional one-stage detectors. Based on the temperature dependence and bias sensitivity of their responsivities with various absorber thicknesses, the diffusion length is estimated to be between 0.6 and 1.0 μm for T2SL materials at high temperatures (>250 K). A comparison of responsivities between current matched ICIPs with varied absorber thicknesses and noncurrent-matched ICIPs with equal absorbers shows that the current-matching among cascade stages is necessary to maximize responsivity. Additionally, electrical gain exceeding unity is demonstrated in these detectors in the reverse-illumination configuration.

  7. Cytokines as a predictor of clinical response following hip arthroscopy: minimum 2-year follow-up.

    PubMed

    Shapiro, Lauren M; Safran, Marc R; Maloney, William J; Goodman, Stuart B; Huddleston, James I; Bellino, Michael J; Scuderi, Gaetano J; Abrams, Geoffrey D

    2016-08-01

    Hip arthroscopy in patients with osteoarthritis has been shown to have suboptimal outcomes. Elevated cytokine concentrations in hip synovial fluid have previously been shown to be associated with cartilage pathology. The purpose of this study was to determine whether a relationship exists between hip synovial fluid cytokine concentration and clinical outcomes at a minimum of 2 years following hip arthroscopy. Seventeen patients without radiographic evidence of osteoarthritis had synovial fluid aspirated at time of portal establishment during hip arthroscopy. Analytes included fibronectin-aggrecan complex as well as a multiplex cytokine array. Patients completed the modified Harris Hip Score, Western Ontario and McMaster Universities Arthritis Index and the International Hip Outcomes Tool pre-operatively and at a minimum of 2 years following surgery. Pre and post-operative scores were compared with a paired t-test, and the association between cytokine values and clinical outcome scores was performed with Pearson's correlation coefficient with an alpha value of 0.05 set as significant. Sixteen of seventeen patients completed 2-year follow-up questionnaires (94%). There was a significant increase in pre-operative to post-operative score for each clinical outcome measure. No statistically significant correlation was seen between any of the intra-operative cytokine values and either the 2-year follow-up scores or the change from pre-operative to final follow-up outcome values. No statistically significant associations were seen between hip synovial fluid cytokine concentrations and 2-year follow-up clinical outcome assessment scores for those undergoing hip arthroscopy.

  8. Two-Year Healthy Eating Outcomes: An RCT in Afterschool Programs.

    PubMed

    Beets, Michael W; Weaver, R Glenn; Turner-McGrievy, Gabrielle; Huberty, Jennifer; Moore, Justin B; Ward, Dianne S; Freedman, Darcy A; Beighle, Aaron

    2017-09-01

    Across the U.S., afterschool programs (ASPs, 3:00pm-6:00pm) are trying to achieve nationally endorsed nutrition standards (Healthy Eating Standards) calling for fruits/vegetables and water to be served every day, while eliminating sugar-sweetened beverages and foods. The purpose of this study was to evaluate the 2-year changes in the types of foods and beverages served during a community-based intervention designed to achieve the Healthy Eating Standards. Randomized delayed treatment trial with an immediate (1-year baseline and 2-year intervention) or delayed (2-year baseline and 1-year intervention) group. Twenty ASPs serving 1,700 children (aged 5-12 years) were recruited, with baseline occurring spring 2013, and outcome assessment occurring spring 2014 and 2015. The multistep intervention, Strategies To Enhance Practice for Healthy Eating, assisted ASP leaders/staff to serve foods/beverages that meet the nutrition standards. The foods and beverages served for snack were observed directly. Compared with non-intervention years, both the immediate and delayed groups increased the number of days/week that fruits/vegetables (0.6 vs 1.7 days/week and 0.6 vs 4.4 days/week, OR=3.80, 95% CI=1.45, 9.95) and water (2.3 vs 3.7 days/week and 2.7 vs 4.8 days/week, OR=4.65, 95% CI=1.69, 12.79) were served. Sugar-sweetened beverages were almost eliminated by post-assessment (1.2 vs 0.2 days/week and 3.2 vs 0.0 days/week, OR=0.05, 95% CI=0.02, 0.13). Only the immediate group decreased the number of days/week desserts were served (2.9 vs 0.6 days/week, OR=0.10, 95% CI=0.03, 0.33). Implementation barriers for the delayed group included once/month delivery schedules for fruits/vegetables and limited storage space for foods meeting the Healthy Eating Standards. Improvements in the foods/beverages served in ASPs can be made, yet were hindered by structural barriers related to procurement and storage of perishable foods. Additional efforts are needed to support ASPs as they work

  9. Outcome at 2 Years after Dextrose Gel Treatment for Neonatal Hypoglycemia: Follow-Up of a Randomized Trial.

    PubMed

    Harris, Deborah L; Alsweiler, Jane M; Ansell, Judith M; Gamble, Gregory D; Thompson, Benjamin; Wouldes, Trecia A; Yu, Tzu-Ying; Harding, Jane E

    2016-03-01

    To determine neurodevelopmental outcome at 2 years' corrected age in children randomized to treatment with dextrose gel or placebo for hypoglycemia soon after birth (The Sugar Babies Study). This was a follow-up study of 184 children with hypoglycemia (<2.6 mM [47 mg/dL]) in the first 48 hours and randomized to either dextrose (90/118, 76%) or placebo gel (94/119, 79%). Assessments were performed at Kahikatea House, Hamilton, New Zealand, and included neurologic function and general health (pediatrician assessed), cognitive, language, behavior, and motor skills (Bayley Scales of Infant and Toddler Development, Third Edition), executive function (clinical assessment and Behaviour Rating Inventory of Executive Function-Preschool Edition), and vision (clinical examination and global motion perception). Coprimary outcomes were neurosensory impairment (cognitive, language or motor score below -1 SD or cerebral palsy or blind or deaf) and processing difficulty (executive function or global motion perception worse than 1.5 SD from the mean). Statistical tests were two sided with 5% significance level. Mean (± SD) birth weight was 3093 ± 803 g and mean gestation was 37.7 ± 1.6 weeks. Sixty-six children (36%) had neurosensory impairment (1 severe, 6 moderate, 59 mild) with similar rates in both groups (dextrose 38% vs placebo 34%, relative risk 1.11, 95% CI 0.75-1.63). Processing difficulty also was similar between groups (dextrose 10% vs placebo 18%, relative risk 0.52, 95% CI 0.23-1.15). Dextrose gel is safe for the treatment of neonatal hypoglycemia, but neurosensory impairment is common among these children. Australian New Zealand Clinical Trials Registry: ACTRN 12608000623392. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Optimization of sound absorbing performance for gradient multi-layer-assembled sintered fibrous absorbers

    NASA Astrophysics Data System (ADS)

    Zhang, Bo; Zhang, Weiyong; Zhu, Jian

    2012-04-01

    The transfer matrix method, based on plane wave theory, of multi-layer equivalent fluid is employed to evaluate the sound absorbing properties of two-layer-assembled and three-layer-assembled sintered fibrous sheets (generally regarded as a kind of compound absorber or structures). Two objective functions which are more suitable for the optimization of sound absorption properties of multi-layer absorbers within the wider frequency ranges are developed and the optimized results of using two objective functions are also compared with each other. It is found that using the two objective functions, especially the second one, may be more helpful to exert the sound absorbing properties of absorbers at lower frequencies to the best of their abilities. Then the calculation and optimization of sound absorption properties of multi-layer-assembled structures are performed by developing a simulated annealing genetic arithmetic program and using above-mentioned objective functions. Finally, based on the optimization in this work the thoughts of the gradient design over the acoustic parameters- the porosity, the tortuosity, the viscous and thermal characteristic lengths and the thickness of each samples- of porous metals are put forth and thereby some useful design criteria upon the acoustic parameters of each layer of porous fibrous metals are given while applying the multi-layer-assembled compound absorbers in noise control engineering.

  11. Factors influencing prognosis and functional outcome one year after a first-time stroke in a Caribbean population.

    PubMed

    Galanth, Sophie; Tressieres, Benoit; Lannuzel, Annie; Foucan, Patrick; Alecu, Cosmin

    2014-11-01

    To evaluate functional outcome and quality of life 1 year poststroke in a Caribbean population. Prospective study of patients with a first hemispheric stroke admitted consecutively between December 2010 and February 2011. The patients were evaluated (1) in the emergency department, (2) when discharged from the hospital, and (3) 1 year poststroke. A university hospital. Of the 140 consecutive patients with stroke, 78 (42% women, 24.4% hemorrhagic stroke) were included in the study. None. Patients were evaluated using the National Institutes of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS), FIM, and Medical Outcomes Study 36-Item Short-Form Health Survey. The mean age of the participants was 62.1±17.7 years; 70.5% of patients had hypertension, 29.4% had diabetes, and 23.6% had chronic renal failure. At 1 year poststroke, the mortality rate was 29.4%, and the recurrence rate 2.6%. We evaluated 39 of the 55 survivors (71%). Score evolution (emergency department vs 1y later) is as follows: for the NIHSS, it was 6.2±4.9 versus 3.3±3.9 (z=-3.578; P<.001); and for the mRS score ≤2, it was 54.2% versus 66.7% (χ(2)=14.182; P=.25). The FIM score on discharge from the hospital versus 1 year later was 103.2±28.2 versus 101.7±31.5 (z=-1.008; P=.313). Multivariate analysis showed that aphasia, hemianopia, and incontinence significantly influenced the 1-year FIM score (P<.001). Quality of life, a patient-reported outcome measure of health-related quality of life, was significantly altered concerning vitality, role physical, and role emotional. One year after a first stroke, despite significant improvement of neurologic impairment, the level of dependency did not change and quality of life was altered. Aphasia, hemianopia, and incontinence significantly influenced functional state. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  12. Accuracy of a dose-area product compared to an absorbed dose to water at a point in a 2 cm diameter field

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Dufreneix, S.; Ostrowsky, A.; Rapp, B.

    Purpose: Graphite calorimeters with a core diameter larger than the beam can be used to establish dosimetric references in small fields. The dose-area product (DAP) measured can theoretically be linked to an absorbed dose at a point by the determination of a profile correction. This study aims at comparing the DAP-based protocol to the usual absorbed dose at a point protocol in a 2 cm diameter field for which both references exist. Methods: Two calorimeters were used, respectively, with a sensitive volume of 0.6 cm (for the absorbed dose at a point measurement) and 3 cm diameter (for the DAPmore » measurement). Profile correction was calculated from a 2D dose mapping using three detectors: a PinPoint chamber, a synthetic diamond, and EBT3 films. A specific protocol to read EBT3 films was implemented and the dose-rate and energy dependences were studied to assure a precise measurement, especially in the penumbra and out-of-field regions. Results: EBT3 films were found independent on dose rates over the range studied but showed a strong under-response (18%) at low energies. Depending on the dosimeter used for calculating the profile correction, a deviation of 0.8% (PinPoint chamber), 0.9% (diamond), or 1.9% (EBT3 films) was observed between the calibration coefficient derived from DAP measurements and the one directly established in terms of absorbed dose to water at a point. Conclusions: The DAP method can currently be linked to the classical dosimetric reference system based in an absorbed dose at a point only with a confidence interval of 95% (k = 2). None of the detectors studied can be used to determine an absorbed dose to water at a point from a DAP measurement with an uncertainty smaller than 1.2%.« less

  13. Maternal educational status at birth, maternal educational advancement, and neurocognitive outcomes at age 10 years among children born extremely preterm.

    PubMed

    Joseph, Robert M; O'Shea, Thomas M; Allred, Elizabeth N; Heeren, Tim; Kuban, Karl K

    2018-04-01

    BackgroundTo determine if a key marker of socioeconomic status, maternal education, is associated with later neurocognitive and academic outcomes among children born extremely preterm (EP).MethodEight hundred and seventy-three children born at 23 to 27 weeks of gestation were assessed for cognitive and academic ability at age 10 years. With adjustments for gestational age (GA) and potential confounders, outcomes of children whose mothers had fewer years of education at the time of delivery and children whose mother advanced in education between birth and 10 years were examined.ResultsChildren of mothers in the lowest education stratum at birth were significantly more likely to score ≥2 SDs below normative expectation on 17 of 18 tests administered. Children of mothers who advanced in education (n=199) were at reduced risk for scoring ≥2 SDs on 15 of 18 measures, but this reduction was statistically significant on only 2 of 18 measures.ConclusionAmong EP children, socioeconomic disadvantage at birth, indexed by maternal education, is associated with significantly poorer neurocognitive and academic outcomes at 10 years of age, independently of GA. Maternal educational advancement during the child's first 10 years of life is associated with modestly improved neurocognitive outcomes.

  14. Unusual solvatochromic absorbance probe behaviour within mixtures of poly(ethylene glycol)-400 + ionic liquid, [bmim][Tf2N

    NASA Astrophysics Data System (ADS)

    Ali, Anwar; Ali, Maroof; Malik, Nisar Ahmad; Uzair, Sahar

    2014-03-01

    The potentially green solvents made up of ionic liquids (ILs) and poly(ethylene glycols) may have wide range of the applications in many chemical and biochemical fields. In the present work, solvatochromic absorbance probe behaviour is used to assess the physicochemical properties of the mixtures composed of PEG-400 + IL, 1-butyl-3-methylimidazolium bis(trifluoromethylsulfonyl)imide, [bmim][Tf2N]. Lowest energy intramolecular charge-transfer absorbance maxima of a betaine dye, i.e., ETN , indicates the dipolarity/polarizability and/or hydrogen-bond donating (HBD) acidity of the [bmim][Tf2N] + PEG-400 mixtures to be even higher than that of neat [bmim][Tf2N], the solution component with higher dipolarity/polarizability and/or HBD acidity. Dipolarity/polarizability (π∗) obtained separately from the electronic absorbance response of probe N,N-diethyl-4-nitroaniline, and the HBD acidity (α) of PEG-400 + [bmim][Tf2N] mixtures are also observed to be anomalously high. A comparative study of the PEG + IL mixtures has also been done with PEG-400 + molecular organic solvents (protic polar [methanol], aprotic polar [N,N-dimethylformamide], and non polar, [benzene]) mixtures, but these mixtures do not show this type of unusual behaviour. A four-parameter simplified combined nearly ideal binary solvent/Redlich-Kister (CNIBS/R-K) equation is shown to satisfactorily predict the solvatochromic parameters within PEG-400 + different solvent mixtures.

  15. Cognitive functioning over 2 years after intracerebral hemorrhage in school-aged children.

    PubMed

    Murphy, Lexa K; Compas, Bruce E; Gindville, Melissa C; Reeslund, Kristen L; Jordan, Lori C

    2017-11-01

    Previous research investigating outcomes after pediatric intracerebral hemorrhage (ICH) has generally been limited to global and sensorimotor outcomes. This study examined cognitive outcomes after spontaneous ICH in school-aged children with serial assessments over 2 years after stroke. Seven children (age range 6-16y, median 13; six males, one female; 57% white, 43% black) presenting with spontaneous ICH (six arteriovenous malformations) were assessed at 3 months, 12 months, and 24 months after stroke. The Pediatric Stroke Outcome Measure (PSOM) quantified neurological outcome and Wechsler Intelligence Scales measured cognitive outcomes: verbal comprehension, perceptual reasoning, working memory, and processing speed. PSOM scales showed improved neurological function over the first 12 months, with mild to no sensorimotor deficits and moderate overall deficits at 1- and 2-year follow-ups (median 2-year sensorimotor PSOM=0.5, total PSOM=1.5). Changes in cognitive function indicated a different trajectory; verbal comprehension and perceptual reasoning improved over 24 months; low performance was sustained in processing speed and working memory. Age-normed centile scores decreased between 1- and 2-year follow-ups for working memory, suggesting emerging deficits compared with peers. Early and serial cognitive testing in children with ICH is needed to assess cognitive functioning and support children in school as they age and cognitive deficits become more apparent and important for function. In children with intracerebral hemorrhage (ICH), motor function improved between 3 months and 24 months. Improvements in cognitive function were variable between 3 months and 24 months. Working memory centiles declined, suggesting emerging deficits compared with peers. Processing speed improved but remained significantly below the 50th centile. Cognitive impact of ICH may increase with age in children. © 2017 Mac Keith Press.

  16. Quasar 2175 Å dust absorbers - I. Metallicity, depletion pattern and kinematics

    NASA Astrophysics Data System (ADS)

    Ma, Jingzhe; Ge, Jian; Zhao, Yinan; Prochaska, J. Xavier; Zhang, Shaohua; Ji, Tuo; Schneider, Donald P.

    2017-12-01

    We present 13 new 2175 Å dust absorbers at zabs = 1.0-2.2 towards background quasars from the Sloan Digital Sky Survey. These absorbers are examined in detail using data from the Echelle Spectrograph and Imager (ESI) on the Keck II telescope. Many low-ionization lines including Fe II, Zn II, Mg II, Si II, Al II, Ni II, Mn II, Cr II, Ti II and Ca II are present in the same absorber that gives rise to the 2175 Å bump. The relative metal abundances (with respect to Zn) demonstrate that the depletion patterns of our 2175 Å dust absorbers resemble that of the Milky Way clouds although some are disc-like and some are halo-like. The 2175 Å dust absorbers have significantly higher depletion levels compared to literature damped Lyman α absorbers (DLAs) and sub-DLAs. The dust depletion level indicator [Fe/Zn] tends to anticorrelate with bump strengths. The velocity profiles from the Keck/ESI spectra also provide kinematical information on the dust absorbers. The dust absorbers are found to have multiple velocity components with velocity widths extending from ∼100 to ∼600 km s-1, which are larger than those of most DLAs and sub-DLAs. Assuming the velocity width is a reliable tracer of stellar mass, the host galaxies of 2175 Å dust absorbers are expected to be more massive than DLA/sub-DLA hosts. Not all of the 2175 Å dust absorbers are intervening systems towards background quasars. The absorbers towards quasars J1006+1538 and J1047+3423 are proximate systems that could be associated with the quasar itself or the host galaxy.

  17. DOC-2/DAB2 Interacting Protein Status in High-Risk Prostate Cancer Correlates With Outcome for Patients Treated With Radiation Therapy

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Jacobs, Corbin; Tumati, Vasu; Kapur, Payal

    2014-07-15

    Purpose: This pilot study investigates the role of DOC-2/DAB2 Interacting Protein (DAB2IP) and enhancer of zeste homolog 2 (EZH2) as prognostic biomarkers in high-risk prostate cancer patients receiving definitive radiation therapy. Methods and Materials: Immunohistochemistry was performed and scored by an expert genitourinary pathologist. Clinical endpoints evaluated were freedom from biochemical failure (FFBF), castration resistance–free survival (CRFS), and distant metastasis–free survival (DMFS). Log-rank test and Cox regression were used to determine significance of biomarker levels with clinical outcome. Results: Fifty-four patients with high-risk prostate cancer (stage ≥T3a, or Gleason score ≥8, or prostate-specific antigen level ≥20 ng/mL) treated with radiation therapy frommore » 2005 to 2012 at our institution were evaluated. Nearly all patients expressed EZH2 (98%), whereas 28% of patients revealed DAB2IP reduction and 72% retained DAB2IP. Median follow-up was 34.0 months for DAB2IP-reduced patients, 29.9 months for DAB2IP-retained patients, and 32.6 months in the EZH2 study. Reduction in DAB2IP portended worse outcome compared with DAB2IP-retained patients, including FFBF (4-year: 37% vs 89%, P=.04), CRFS (4-year: 50% vs 90%, P=.02), and DMFS (4-year: 36% vs 97%, P=.05). Stratified EZH2 expression trended toward significance for worse FFBF and CRFS (P=.07). Patients with reduced DAB2IP or highest-intensity EZH2 expression exhibited worse FFBF (4-year: 32% vs 95%, P=.02), CRFS (4-year: 28% vs 100%, P<.01), and DMFS (4-year: 39% vs 100%, P=.04) compared with the control group. Conclusion: Loss of DAB2IP is a potent biomarker that portends worse outcome despite definitive radiation therapy for patients with high-risk prostate cancer. Enhancer of zeste homolog 2 is expressed in most high-risk tumors and is a less potent discriminator of outcome in this study. The DAB2IP status in combination with degree of EZH2 expression may be useful for

  18. Predictors of outcomes after arthroscopic transosseous equivalent rotator cuff repair in 155 cases: a propensity score weighted analysis of knotted and knotless self-reinforcing repair techniques at a minimum of 2 years.

    PubMed

    Millett, Peter J; Espinoza, Chris; Horan, Marilee P; Ho, Charles P; Warth, Ryan J; Dornan, Grant J; Christoph Katthagen, J

    2017-10-01

    To evaluate the outcomes of two commonly used transosseous-equivalent (TOE) arthroscopic rotator cuff repair (RCR) techniques for full-thickness supraspinatus tendon tears (FTST) using a robust multi-predictor model. 155 shoulders in 151 patients (109 men, 42 women; mean age 59 ± 10 years) who underwent arthroscopic RCR of FTST, using either a knotted suture bridging (KSB) or a knotless tape bridging (KTB) TOE technique were included. ASES and SF-12 PCS scores assessed at a minimum of 2 years postoperatively were modeled using propensity score weighting in a multiple linear regression model. Patients able to return to the study center underwent a follow-up MRI for evaluation of rotator cuff integrity. The outcome data were available for 137 shoulders (88%; n = 35/41 KSB; n = 102/114 KTB). Seven patients (5.1%) that underwent revision rotator cuff surgery were considered failures. The median postoperative ASES score of the remaining 130 shoulders was 98 at a mean follow-up of 2.9 years (range 2.0-5.4 years). A higher preoperative baseline outcome score and a longer follow-up had a positive effect, whereas a previous RCR and workers' compensation claims (WCC) had a negative effect on final ASES or SF 12 PCS scores. The repair technique, age, gender and the number of anchors used for the RCR had no significant influence. Fifty-two patients returned for a follow-up MRI at a mean of 4.4 years postoperatively. Patients with a KSB RCR were significantly more likely to have an MRI-diagnosed full-thickness rotator cuff re-tear (p < 0.05). Excellent outcomes can be achieved at a minimum of 2 years following arthroscopic KSB or KTB TOE RCR of FTST. The preoperative baseline outcome score, a prior RCR, WCC and the length of follow-up significantly influenced the outcome scores. The repair technique did not affect the final functional outcomes, but patients with KTB TOE RCR were less likely to have a full-thickness rotator cuff re-tear. Level III, Retrospective

  19. Sound Absorbers

    NASA Astrophysics Data System (ADS)

    Fuchs, H. V.; Möser, M.

    Sound absorption indicates the transformation of sound energy into heat. It is, for instance, employed to design the acoustics in rooms. The noise emitted by machinery and plants shall be reduced before arriving at a workplace; auditoria such as lecture rooms or concert halls require a certain reverberation time. Such design goals are realised by installing absorbing components at the walls with well-defined absorption characteristics, which are adjusted for corresponding demands. Sound absorbers also play an important role in acoustic capsules, ducts and screens to avoid sound immission from noise intensive environments into the neighbourhood.

  20. Socioeconomic Outcomes in Adults Malnourished in the First Year of Life: A 40-Year Study

    PubMed Central

    Bryce, Cyralene; Waber, Deborah P.; Zichlin, Miriam L.; Fitzmaurice, Garret M.; Eaglesfield, David

    2012-01-01

    OBJECTIVE: Lifelong functional, adaptive, and economic outcomes of moderate to severe infantile malnutrition are not well known. We assessed social status and income at midlife in a cohort of Barbadian adults, hospitalized for protein-energy malnutrition (PEM) during the first year of life, with good nutrition and health thereafter, in the context of a 40-year longitudinal case-control study. We also examined to what extent childhood IQ mediated any group differences. METHODS: Educational achievement, occupational status, and standard of living were assessed by the Hollingshead scales and a site-specific Ecology Questionnaire in Barbadian adults (aged 37–43 years) with a history of malnutrition (n = 80) and a matched healthy control group (n = 63), classmates of the index cases. Malnutrition effects, adjusted for childhood standard of living, were estimated by longitudinal multiple regression analyses, with and without childhood IQ, in the models. RESULTS: PEM predicted poorer socioeconomic outcomes with medium to large effect sizes (0.50–0.94), but childhood IQ substantially attenuated the magnitude of these effects (adjusted effect sizes: 0.17–0.34). The gap in weekly household income between the PEM and control groups increased substantially over the life span (P < .001). CONCLUSIONS: Moderate to severe PEM during the first year of life with adequate nutrition and health care thereafter is associated with significant depression of socioeconomic outcomes in adulthood, mediated in part by cognitive compromise in affected individuals. This finding underscores the potential long-term economic burden of infant malnutrition, which is of major concern given the continued high prevalence of malnutrition worldwide. PMID:22732170

  1. Effect of nicotine patches in pregnancy on infant and maternal outcomes at 2 years: follow-up from the randomised, double-blind, placebo-controlled SNAP trial.

    PubMed

    Cooper, Sue; Taggar, Jaspal; Lewis, Sarah; Marlow, Neil; Dickinson, Anne; Whitemore, Rachel; Coleman, Tim

    2014-09-01

    The SNAP (Smoking and Nicotine in Pregnancy) trial compared nicotine replacement therapy (NRT) patches with placebo in pregnant smokers; although NRT doubled cessation rates in the first 4 weeks, by delivery no differences in maternal smoking or birth outcomes were noted. As a result, NRT used in standard doses during pregnancy is considered ineffective for smoking cessation. Subsequent effects of NRT on the children of treated mothers are unknown because no trials have investigated the effect of gestational NRT use beyond birth. To assess whether NRT use in pregnancy might cause harm to infants, we aimed to compare effects of NRT and placebo on infant development 2 years after delivery. 1050 pregnant smokers aged 16-45 years, at 12-24 weeks' gestation, and smoking at least five cigarettes per day were recruited from seven hospitals in England between May 1, 2007, and Feb 26, 2010, and followed up until their infants were 2 years old. Participants were randomly assigned (1:1) to receive up to 8-weeks treatment with NRT (15 mg/16 h transdermal patches) or identically packaged and visually matched placebo patches (all patches manufactured by and purchased at market rate from United Pharmaceuticals, Amman, Jordan), issued as two 4-week supplies (521 for NRT group, 529 for placebo group) [Corrected]. Randomisation was stratified by site with participants, health-care professionals, and research staff masked to treatment allocation. The primary results for participants and infants at delivery were published in 2012; we present results from the trial cohort 2 years after birth. After delivery, questionnaires were posted to participants and, if there was no response, to family physicians. The primary outcome at 2 years was infants' survival without developmental impairment (ie, no disability or problems with behaviour or development). Treatment groups were compared on an intention-to-treat basis. The trial is registered with Controlled-Trials.com, number ISRCTN07249128

  2. Mortality and One-Year Functional Outcome in Elderly and Very Old Patients with Severe Traumatic Brain Injuries: Observed and Predicted

    PubMed Central

    Røe, Cecilie; Skandsen, Toril; Manskow, Unn; Ader, Tiina; Anke, Audny

    2015-01-01

    The aim of the present study was to evaluate mortality and functional outcome in old and very old patients with severe traumatic brain injury (TBI) and compare to the predicted outcome according to the internet based CRASH (Corticosteroid Randomization After Significant Head injury) model based prediction, from the Medical Research Council (MRC). Methods. Prospective, national multicenter study including patients with severe TBI ≥65 years. Predicted mortality and outcome were calculated based on clinical information (CRASH basic) (age, GCS score, and pupil reactivity to light), as well as with additional CT findings (CRASH CT). Observed 14-day mortality and favorable/unfavorable outcome according to the Glasgow Outcome Scale at one year was compared to the predicted outcome according to the CRASH models. Results. 97 patients, mean age 75 (SD 7) years, 64% men, were included. Two patients were lost to follow-up; 48 died within 14 days. The predicted versus the observed odds ratio (OR) for mortality was 2.65. Unfavorable outcome (GOSE < 5) was observed at one year follow-up in 72% of patients. The CRASH models predicted unfavorable outcome in all patients. Conclusion. The CRASH model overestimated mortality and unfavorable outcome in old and very old Norwegian patients with severe TBI. PMID:26688614

  3. Absorber Model: the Halo-like model for the Lyman-α forest

    NASA Astrophysics Data System (ADS)

    Iršič, Vid; McQuinn, Matthew

    2018-04-01

    We present a semi-analytic model for the Lyman-α forest that is inspired by the Halo Model. This model is built on the absorption line decomposition of the forest. Flux correlations are decomposed into those within each absorption line (the 1-absorber term) and those between separate lines (the 2-absorber term), treating the lines as biased tracers of the underlying matter fluctuations. While the nonlinear exponential mapping between optical depth and flux requires an infinite series of moments to calculate any statistic, we show that this series can be re-summed (truncating at the desired order in the linear matter overdensity). We focus on the z=2–3 line-of-sight power spectrum. Our model finds that 1-absorber term dominates the power on all scales, with most of its contribution coming from H I columns of 1014–1015 cm‑2, while the smaller 2-absorber contribution comes from lower columns that trace overdensities of a few. The prominence of the 1-absorber correlations indicates that the line-of-sight power spectrum is shaped principally by the lines' number densities and their absorption profiles, with correlations between lines contributing to a lesser extent. We present intuitive formulae for the effective optical depth as well as the large-scale limits of 1-absorber and 2-absorber terms, which simplify to integrals over the H I column density distribution with different equivalent-width weightings. With minimalist models for the bias of absorption systems and their peculiar velocity broadening, our model predicts values for the density bias and velocity gradient bias that are consistent with those found in simulations.

  4. Ten-year outcomes of a randomised trial of laparoscopic versus open surgery for colon cancer.

    PubMed

    Deijen, Charlotte L; Vasmel, Jeanine E; de Lange-de Klerk, Elly S M; Cuesta, Miguel A; Coene, Peter-Paul L O; Lange, Johan F; Meijerink, W J H Jeroen; Jakimowicz, Jack J; Jeekel, Johannes; Kazemier, Geert; Janssen, Ignace M C; Påhlman, Lars; Haglind, Eva; Bonjer, H Jaap

    2017-06-01

    Laparoscopic surgery for colon cancer is associated with improved recovery and similar cancer outcomes at 3 and 5 years in comparison with open surgery. However, long-term survival rates have rarely been reported. Here, we present survival and recurrence rates of the Dutch patients included in the COlon cancer Laparoscopic or Open Resection (COLOR) trial at 10-year follow-up. Between March 1997 and March 2003, patients with non-metastatic colon cancer were recruited by 29 hospitals in eight countries and randomised to either laparoscopic or open surgery. Main inclusion criterion for the COLOR trial was solitary adenocarcinoma of the left or right colon. The primary outcome was disease-free survival at 3 years, and secondary outcomes included overall survival and recurrence. The 10-year follow-up data of all Dutch patients were collected. Analysis was by intention-to-treat. The trial was registered at ClinicalTrials.gov (NCT00387842). In total, 1248 patients were randomised, of which 329 were Dutch. Fifty-eight Dutch patients were excluded and 15 were lost to follow-up, leaving 256 patients for 10-year analysis. Median follow-up was 112 months. Disease-free survival rates were 45.2 % in the laparoscopic group and 43.2 % in the open group (difference 2.0 %; 95 % confidence interval (CI) -10.3 to 14.3; p = 0.96). Overall survival rates were 48.4 and 46.7 %, respectively (difference 1.7 %; 95 % CI -10.6 to 14.0; p = 0.83). Stage-specific analysis revealed similar survival rates for both groups. Sixty-two patients were diagnosed with recurrent disease, accounting for 29.4 % in the laparoscopic group and 28.2 % in the open group (difference 1.2 %; 95 % CI -11.1 to 13.5; p = 0.73). Seven patients had port- or wound-site recurrences (laparoscopic n = 3 vs. open n = 4). Laparoscopic surgery for non-metastatic colon cancer is associated with similar rates of disease-free survival, overall survival and recurrences as open surgery at 10-year follow-up.

  5. Integration of regenerative shock absorber into vehicle electric system

    NASA Astrophysics Data System (ADS)

    Zhang, Chongxiao; Li, Peng; Xing, Shaoxu; Kim, Junyoung; Yu, Liangyao; Zuo, Lei

    2014-03-01

    Regenerative/Energy harvesting shock absorbers have a great potential to increase fuel efficiency and provide suspension damping simultaneously. In recent years there's intensive work on this topic, but most researches focus on electricity extraction from vibration and harvesting efficiency improvement. The integration of electricity generated from regenerative shock absorbers into vehicle electric system, which is very important to realize the fuel efficiency benefit, has not been investigated. This paper is to study and demonstrate the integration of regenerative shock absorber with vehicle alternator, battery and in-vehicle electrical load together. In the presented system, the shock absorber is excited by a shaker and it converts kinetic energy into electricity. The harvested electricity flows into a DC/DC converter which realizes two functions: controlling the shock absorber's damping and regulating the output voltage. The damping is tuned by controlling shock absorber's output current, which is also the input current of DC/DC converter. By adjusting the duty cycles of switches in the converter, its input impedance together with input current can be adjusted according to dynamic damping requirements. An automotive lead-acid battery is charged by the DC/DC converter's output. To simulate the working condition of combustion engine, an AC motor is used to drive a truck alternator, which also charges the battery. Power resistors are used as battery's electrical load to simulate in-vehicle electrical devices. Experimental results show that the proposed integration strategy can effectively utilize the harvested electricity and power consumption of the AC motor is decreased accordingly. This proves the combustion engine's load reduction and fuel efficiency improvement.

  6. FIVE-YEAR OUTCOMES OF INTRAVITREAL RANIBIZUMAB FOR CHOROIDAL NEOVASCULARIZATION IN PATIENTS WITH PATHOLOGIC MYOPIA.

    PubMed

    Onishi, Yuka; Yokoi, Tae; Kasahara, Kaori; Yoshida, Takeshi; Nagaoka, Natsuko; Shinohara, Kosei; Kaneko, Yuichiro; Suga, Mitsuki; Uramoto, Kengo; Ohno-Tanaka, Akiko; Ohno-Matsui, Kyoko

    2018-05-03

    To determine the 5-year outcome of intravitreal ranibizumab (IVR) for myopic choroidal neovascularization (CNV). We retrospectively analyzed the medical records of 51 eyes of 51 consecutive patients with myopic CNV who had been treated with IVR with a minimum follow-up period of 5 years after the initial IVR injection. The factors that predicted the best-corrected visual acuity (BCVA) at 5 years after IVR were determined by multiple regression analysis. The mean age of the subjects was 63.6 years, and the mean axial length was 29.4 mm. The mean number of IVR was 1.6, and 34 eyes (66.7%) had only a single IVR. At the baseline and at the 1-year, 2-year, 4-year, and 5-year period, the mean BCVAs were 20/49, 20/37, 20/41, 20/45, and 20/42, respectively. Stepwise multiple regression analysis showed that the BCVA at 5-year period was significantly correlated with the baseline BCVA, the number of IVR injections, and the size of the CNV-related macular atrophy. Intravitreal ranibizumab provide a 5-year visual benefit in eyes with myopic CNV compared with the natural course. A lack of enlargement of the CNV-related macular atrophy, a better baseline BCVA, and a minimum number of IVR injections were associated with better visual outcomes.

  7. Five-year Treatment Outcomes in the Ahmed Baerveldt Comparison Study

    PubMed Central

    Budenz, Donald L.; Barton, Keith; Gedde, Steven J.; Feuer, William J.; Schiffman, Joyce; Costa, Vital P.; Godfrey, David G.; Buys, Yvonne M.

    2014-01-01

    Purpose To compare the five year outcomes of the Ahmed FP7 Glaucoma Valve (AGV) and the Baerveldt 101-350 Glaucoma Implant (BGI) for the treatment of refractory glaucoma. Design Multicenter randomized controlled clinical trial. Participants 276 patients, including 143 in the AGV group and 133 in the BGI group. Methods Patients 18 to 85 years of age with previous intraocular surgery or refractory glaucoma and intraocular pressure (IOP) of ≥ 18 mmHg in whom glaucoma drainage implant surgery was planned were randomized to implantation of either an AGV or BGI. Main Outcome Measures IOP, visual acuity, use of glaucoma medications, complications, and failure (IOP > 21 mmHg or not reduced by 20% from baseline, IOP ≤ 5 mmHg, reoperation for glaucoma, removal of implant, or loss of light perception). Results At 5 years, IOP (mean ± SD) was 14.7 ± 4.4 mmHg in the AGV group and 12.7 ± 4.5 mmHg in the BGI group (p = 0.012). The number of glaucoma medications in use at 5 years (mean ± SD) was 2.2 ± 1.4 in the AGV group and 1.8 ± 1.5 in the BGI group (p = 0.28). The cumulative probability of failure during 5 years of follow-up was 44.7% in the AGV group and 39.4% in the BGI group (p = 0.65). The number of subjects failing due to inadequately controlled IOP or reoperation for glaucoma was 46 in the AGV group (80% of AGV failures) and 25 in the BGI group (53% of BGI failures, p=0.003). Eleven AGV eyes (20% of AGV failures) experienced persistent hypotony, explantation of implant, or loss of light perception compared to 22 (47% of failures) in the BGI group. The 5-year cumulative reoperation rate for glaucoma was 20.8% in the AGV group compared to 8.6% in the BGI group (p=0.010). Change in logMAR Snellen visual acuity (mean ± SD) at 5 years was 0.42 ± 0.99 in the AGV group and 0.43 ± 0.84 in the BGI group (p=0.97). Conclusions Similar rates of surgical success were observed with both implants at 5 years. BGI implantation produced greater IOP reduction and a lower rate

  8. Preparation and microwave absorbing properties of carbon/cobalt ferromagnetic composites.

    PubMed

    Li, Wangchang; Qiao, Xiaojing; Zhao, Hui; Wang, Shuman; Ren, Qingguo

    2013-02-01

    Carbon/cobalt ferromagnetic light composites with high performance of microwave absorbing properties were prepared by hydrothermal method using starch and hollow cobalt ferrites. It was concluded that after carbonization the spinel structure ferrites changed to Co3Fe7 alloys and the temperature of graphitization was significantly decreased for the catalytic of CoFe2O4/Co3Fe7. The increase of carbon content, and exist of CoFe2O4/Co3Fe7 heightened the microwave absorbing properties. Electromagnetic parameters were tested with 40% of the titled materials and 60% of paraffin wax composites by using HP8722ES vector network analyzer. The reflection was also simulated through transmission line theory. The microwave absorbers exhibited a maximum reflection loss -43 dB and the electromagnetic wave absorption less than -10 dB was found to exceed 3.0 GHz between 11.6 GHz and 15 GHz for an absorber thickness of 2 mm.

  9. Ultraviolet light absorbers having two different chromophors in the same molecule

    DOEpatents

    Vogl, O.; Li, S.

    1983-10-06

    This invention relates to novel ultraviolet light absorbers having two chromophors in the same molecule, and more particularly to benzotriazole substituted dihydroxybenzophenones and acetophenones. More particularly, this invention relates to 3,5-(di(2H-benzotriazole-2-yl))-2,4-dihydroxybenzophenone and 3,5-(di(2H-benzotriazole-2-yl))-2,4-dihydroxyacetophenone which are particularly useful as an ultraviolet light absorbers.

  10. Parenting behavior at 2 years predicts school-age performance at 7 years in very preterm children.

    PubMed

    Treyvaud, Karli; Doyle, Lex W; Lee, Katherine J; Ure, Alexandra; Inder, Terrie E; Hunt, Rod W; Anderson, Peter J

    2016-07-01

    Parenting influences child development, but it is unclear whether early parenting behavior can influence school-age outcomes in very preterm (VPT) children, and/or if certain groups of VPT children may be more affected by early parenting behavior. These research questions were examined. Participants were 147 children born <30 weeks' gestation or birth weight <1250 g and their primary caregiver. At term corrected age (CA), magnetic resonance imaging (MRI) was used to determine presence and severity of brain abnormality and medical data collected. High medical risk was defined as the presence of at least one of sepsis, necrotizing enterocolitis, bronchopulmonary dysplasia, moderate to severe white matter abnormality on MRI, or postnatal corticosteroids. At 2 years CA, parent-child interaction was assessed, and at 7 years CA, general intelligence (IQ), language, executive function, academic skills, and social-emotional functioning were assessed. Higher levels of parent-child synchrony, and parent facilitation, sensitivity and positive affect at 2 years were associated with better child outcomes at 7 years, while higher levels of intrusiveness and negative affect were associated with poorer outcomes. Many of these relationships remained after controlling for early child cognitive development. Interactions between child medical risk (higher/lower) and parenting were limited to child reading, math, and executive functioning outcomes, with stronger relationships for lower medical risk children. The contribution of early parenting to VPT children's school-age performance is significant, with stronger effects for lower medical risk children in some outcomes. These findings support the premise that parenting strategies should be included in the NICU and early interventions programs for VPT infants. © 2015 Association for Child and Adolescent Mental Health.

  11. Pregnancy Outcome in Women with Threatened Miscarriage: a Year Study

    PubMed Central

    Ahmed, Salah Roshdy; El-Sammani, Mohamed El-Khatem; Al-Sheeha, Muneera Al-Alaziz; Aitallah, Abdou Saeed; Jabin Khan, Farhat; Ahmed, Salah Roshdy

    2012-01-01

    Introduction: Patients with threatened miscarriage associated with adverse pregnancy outcomes because of associated pregnancy and labor complications. Objectives: To evaluate the effect of threatened miscarriage on early and late pregnancy outcome. Methods: A retrospective case–controlled study was performed on 89 women with threatened miscarriage (study group) at Maternity and Children Hospital Buraidah, KSA from January 2010 to December 2010. They were matched for age and parity to 45 cases (control group) attending route antenatal clinic at the same time. Data recorded included, demographic characteristics and detailed pregnancy outcome and ultrasound finding including gestational age, cardiac activity and subchorionic hematoma. Results: The overall adverse pregnancy outcome was significantly higher in the studied cases compared to the control group (p=015).The miscarriage rate was significantly higher in study group compared to the controls group, (16.9%vs 2.2%, p=0000). Preterm delivery, babies with low birth weight and premature rupture of membranes were significantly higher in the miscarriage group compared to the controls group, (15.7% vs 2.2%, p=0.001), (15.7% vs 2.2%), p=0.001) and (6.7%) vs 4.45), p=0.016). There were no significant differences in other pregnancy outcomes. Conclusion: threatened miscarriage is associated with increased incidence of adverse pregnancy outcome. The risk is specially increased in premature rupture of the membranes, preterm delivery and neonatal birth weight. PMID:23678307

  12. Edifoligide and long-term outcomes after coronary artery bypass grafting: PRoject of Ex-vivo Vein graft ENgineering via Transfection IV (PREVENT IV) 5-year results.

    PubMed

    Lopes, Renato D; Williams, Judson B; Mehta, Rajendra H; Reyes, Eric M; Hafley, Gail E; Allen, Keith B; Mack, Michael J; Peterson, Eric D; Harrington, Robert A; Gibson, C Michael; Califf, Robert M; Kouchoukos, Nicholas T; Ferguson, T Bruce; Lorenz, Todd J; Alexander, John H

    2012-09-01

    Edifoligide, an E2F transcription factor decoy, does not prevent vein graft failure or adverse clinical outcomes at 1 year in patients undergoing coronary artery bypass grafting (CABG). We compared the 5-year clinical outcomes of patients in PREVENT IV treated with edifoligide and placebo to identify predictors of long-term clinical outcomes. A total of 3,014 patients undergoing CABG with at least 2 planned vein grafts were enrolled. Kaplan-Meier curves were generated to compare the long-term effects of edifoligide and placebo. A Cox proportional hazards model was constructed to identify factors associated with 5-year post-CABG outcomes. The main outcome measures were death, myocardial infarction (MI), repeat revascularization, and rehospitalization through 5 years. Five-year follow-up was complete in 2,865 patients (95.1%). At 5 years, patients randomized to edifoligide and placebo had similar rates of death (11.7% and 10.7%, respectively), MI (2.3% and 3.2%), revascularization (14.1% and 13.9%), and rehospitalization (61.6% and 62.5%). The composite outcome of death, MI, or revascularization occurred at similar frequency in patients assigned to edifoligide and placebo (26.3% and 25.5%, respectively; hazard ratio 1.03 [95% CI 0.89-1.18], P = .721). Factors associated with death, MI, or revascularization at 5 years included peripheral and/or cerebrovascular disease, time on cardiopulmonary bypass, lung disease, diabetes mellitus, and congestive heart failure. Up to a quarter of patients undergoing CABG will have a major cardiac event or repeat revascularization procedure within 5 years of surgery. Edifoligide does not affect outcomes after CABG; however, common identifiable baseline and procedural risk factors are associated with long-term outcomes after CABG. Copyright © 2012 Mosby, Inc. All rights reserved.

  13. Bleb needling outcomes for failed trabeculectomy blebs in Asian eyes: a 2-year follow up.

    PubMed

    Tsai, Andrew S H; Boey, Pui Yi; Htoon, Hla M; Wong, Tina T

    2015-01-01

    To describe the outcomes of bleb needling in primary glaucoma in an Asian tertiary eye centre over a 2y period. To compare the success rates between primary angle-closure glaucoma (PACG) and primary open angle glaucoma (POAG). Lastly, to identify factors associated with success of bleb needling. This was a retrospective review of 227 patients who underwent bleb needling between June 2009 and June 2011 in Singapore National Eye Centre. The 5-fluorouracil (5-FU) augmented bleb needling was performed either at the slit lamp or in the operating theatre. Repeat bleb needlings were performed as necessary. Complete success was defined as maintenance of intraocular pressure (IOP) ≥6 mm Hg and ≤21 mm Hg, in the absence of further surgery or use of antiglaucoma medication. Qualified success met the above criteria with or without use of antiglaucoma medications. One hundred and seventy-five eyes completed the two-year follow up. Sixty-nine percent of participants had POAG and 31% had PACG. The mean interval between filtering surgery and bleb needling was 299.9±616.4d for POAG and 167.1±272.2d for PACG. Mean needling attempts were 1.9±1.4 and 2±1.6 for POAG and PACG respectively. In general, there was a statistically significant reduction of IOP ranging from 21.9% to 26.8% from month 1 through to month 24. The complete success rates at month 6 were 70.0% for POAG and 65.7% for PACG. At month 12, this decreased to 62.2% for POAG and PACG and at month 24, 57.9% for POAG and 63.0% for PACG respectively. The qualified success rates at month 6 for POAG and PACG were 23.8% and 29.9% respectively, 32.2% and 29.2% at month 12, and 34.7% and 29.6% at month 24. The success rates between POAG and PACG were not significantly different (P>0.05 for complete and qualified success at months 6, 12 and 24). An increased number of needlings and higher pre-needling IOP were associated with failure. The 5-FU augmented bleb needling within one year of trabeculectomy in Asian eyes can

  14. Bleb needling outcomes for failed trabeculectomy blebs in Asian eyes: a 2-year follow up

    PubMed Central

    Tsai, Andrew S. H.; Boey, Pui Yi; Htoon, Hla M; Wong, Tina T

    2015-01-01

    AIM To describe the outcomes of bleb needling in primary glaucoma in an Asian tertiary eye centre over a 2y period. To compare the success rates between primary angle-closure glaucoma (PACG) and primary open angle glaucoma (POAG). Lastly, to identify factors associated with success of bleb needling. METHODS This was a retrospective review of 227 patients who underwent bleb needling between June 2009 and June 2011 in Singapore National Eye Centre. The 5-fluorouracil (5-FU) augmented bleb needling was performed either at the slit lamp or in the operating theatre. Repeat bleb needlings were performed as necessary. Complete success was defined as maintenance of intraocular pressure (IOP) ≥6 mm Hg and ≤21 mm Hg, in the absence of further surgery or use of antiglaucoma medication. Qualified success met the above criteria with or without use of antiglaucoma medications. RESULTS One hundred and seventy-five eyes completed the two-year follow up. Sixty-nine percent of participants had POAG and 31% had PACG. The mean interval between filtering surgery and bleb needling was 299.9±616.4d for POAG and 167.1±272.2d for PACG. Mean needling attempts were 1.9±1.4 and 2±1.6 for POAG and PACG respectively. In general, there was a statistically significant reduction of IOP ranging from 21.9% to 26.8% from month 1 through to month 24. The complete success rates at month 6 were 70.0% for POAG and 65.7% for PACG. At month 12, this decreased to 62.2% for POAG and PACG and at month 24, 57.9% for POAG and 63.0% for PACG respectively. The qualified success rates at month 6 for POAG and PACG were 23.8% and 29.9% respectively, 32.2% and 29.2% at month 12, and 34.7% and 29.6% at month 24. The success rates between POAG and PACG were not significantly different (P>0.05 for complete and qualified success at months 6, 12 and 24). An increased number of needlings and higher pre-needling IOP were associated with failure. CONCLUSION The 5-FU augmented bleb needling within one year of

  15. Optical analysis of solar energy tubular absorbers.

    PubMed

    Saltiel, C; Sokolov, M

    1982-11-15

    The energy absorbed by a solar energy tubular receiver element for a single incident ray is derived. Two types of receiver elements were analyzed: (1) an inner tube with an absorbing coating surrounded by a semitransparent cover tube, and (2) a semitransparent inner tube filled with an absorbing fluid surrounded by a semitransparent cover tube. The formation of ray cascades in the semitransparent tubes is considered. A numerical simulation to investigate the influence of the angle of incidence, sizing, thickness, and coefficient of extinction of the tubes was performed. A comparison was made between receiver elements with and without cover tubes. Ray tracing analyses in which rays were followed within the tubular receiver element as well as throughout the rest of the collector were performed for parabolic and circular trough concentrating collectors.

  16. On the design of learning outcomes for the undergraduate engineer's final year project

    NASA Astrophysics Data System (ADS)

    Thambyah, Ashvin

    2011-03-01

    The course for the final year project for engineering students, because of its strongly research-based, open-ended format, tends to not have well defined learning outcomes, which are also not aligned with any accepted pedagogical philosophy or learning technology. To address this problem, the revised Bloom's taxonomy table of Anderson and Krathwohl (2001) is utilised, as suggested previously by Lee and Lai (2007), to design new learning outcomes for the final year project course in engineering education. Based on the expectations of the engineering graduate, and integrating these graduate expectations into the six cognitive processes and four knowledge dimensions of the taxonomy table, 24 learning outcomes have been designed. It is proposed that these 24 learning outcomes be utilised as a suitable working template to inspire more critical evaluation of what is expected to be learnt by engineering students undertaking final year research or capstone projects.

  17. Glomerular diseases outcome at one year in a tertiary care centre

    PubMed Central

    Mahmud, Huma Mamun; Kumar, Darshan; Irum, Humera; Farman Ali, Syed

    2015-01-01

    Objectives: To determine outcome in primary and secondary glomerular diseases at one year follow up. Methods: Study design is observational cohort, done in out-patient department, Dow Iinternational Medical College, DUHS. All information gathered on a proforma. All patients with dipstick positive proteinuria and clinical glomerular disease were included in study. Patients with no proteinuria were excluded so were patients with stage 5 CKD. Patients were followed for proteinuria and renal insufficiency at completion of one year follow up. Statistical analysis was done on SPSS version 16. Result: Total number of patients who completed one year follow up was 173. Mean age of patients was 51.67+ 10.16 (range 15 to 75 years). Ninety two (53.2%), were males and 81(46.8%) were females, ratio being 1.1: 1.0. Mean weight of our patients was 67.43+ 14.13 Kg, (35 to 107 kg). Commonest cause of glomerular disease in our patient was diabetic nephropathy which was seen in 94.2% patients. Commonest associated problem with glomerular disease was hypertension seen in 66.5% of patients. Four out of 173 patients had stage 5 CKD at end of follow up at one year while quantitativ proteinuria remained same at one year follow up. Conclusion: One year follow up is critical for patients with glomerular disease associated with stage 4 CKD as progression to end stage renal failure may be seen within one year in these patients. PMID:26101512

  18. Metal-shearing energy absorber

    NASA Technical Reports Server (NTRS)

    Fay, R. J.; Wittrock, E. P.

    1971-01-01

    Device, consisting of tongue of thin aluminum alloy strip, pull tab, slotted steel plate which serves as cutter, and steel buckle, absorbs mechanical energy when its ends are subjected to tensile loading. Device is applicable as auxiliary shock absorbing anchor for automobile and airplane safety belts.

  19. Properties of the ferroelectric visible light absorbing semiconductors: Sn 2 P 2 S 6 and Sn 2 P 2 Se 6

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Li, Yuwei; Singh, David J.

    Ferroelectrics with suitable band gaps have recently attracted attention as candidate solar absorbing materials for photovoltaics. The inversion symmetry breaking may promote the separation of photoexcited carriers and allow voltages higher than the band gap. However, these effects are not fully understood, in part because of a lack of suitable model systems for studying these effects in detail. Here, we report properties of ferroelectric Sn 2P 2S 6 and Sn 2P 2Se 6 using first principles calculations. Results are given for the electronic structure, carrier pocket shapes, optical absorption, and transport.We find indirect band gaps of 2.20 eV and 1.55more » eV, respectively, and favorable band structures for carrier transport, including both holes and electrons. Strong absorption is found above the direct gaps of 2.43 eV and 1.76 eV. Furthermore these compounds may serve as useful model systems for understanding photovoltaic effects in ferroelectric semiconductors.« less

  20. Properties of the ferroelectric visible light absorbing semiconductors: Sn 2 P 2 S 6 and Sn 2 P 2 Se 6

    DOE PAGES

    Li, Yuwei; Singh, David J.

    2017-12-05

    Ferroelectrics with suitable band gaps have recently attracted attention as candidate solar absorbing materials for photovoltaics. The inversion symmetry breaking may promote the separation of photoexcited carriers and allow voltages higher than the band gap. However, these effects are not fully understood, in part because of a lack of suitable model systems for studying these effects in detail. Here, we report properties of ferroelectric Sn 2P 2S 6 and Sn 2P 2Se 6 using first principles calculations. Results are given for the electronic structure, carrier pocket shapes, optical absorption, and transport.We find indirect band gaps of 2.20 eV and 1.55more » eV, respectively, and favorable band structures for carrier transport, including both holes and electrons. Strong absorption is found above the direct gaps of 2.43 eV and 1.76 eV. Furthermore these compounds may serve as useful model systems for understanding photovoltaic effects in ferroelectric semiconductors.« less

  1. The Development of Two Composite Energy Absorbers for Use in a Transport Rotorcraft Airframe Crash Testbed (TRACT 2) Full-Scale Crash Test

    NASA Technical Reports Server (NTRS)

    Littell, Justin D.; Jackson, Karen E.; Annett, Martin S.; Seal, Michael D.; Fasanella, Edwin L.

    2015-01-01

    Two composite energy absorbers were developed and evaluated at NASA Langley Research Center through multi-level testing and simulation performed under the Transport Rotorcraft Airframe Crash Testbed (TRACT) research program. A conical-shaped energy absorber, designated the conusoid, was evaluated that consisted of four layers of hybrid carbon-Kevlar plain weave fabric oriented at [+45deg/-45deg/-45deg/+45deg] with respect to the vertical direction. A sinusoidal-shaped energy absorber, designated the sinusoid, was developed that consisted of hybrid carbon-Kevlar plain weave fabric face sheets, two layers for each face sheet oriented at +/-45deg with respect to the vertical direction, and a closed-cell ELFOAM P200 polyisocyanurate (2.0-lb/cu ft) foam core. The design goal for the energy absorbers was to achieve average floor-level accelerations of between 25- and 40-g during the full-scale crash test of a retrofitted CH-46E helicopter airframe, designated TRACT 2. Variations in both designs were assessed through dynamic crush testing of component specimens. Once the designs were finalized, subfloor beams of each configuration were fabricated and retrofitted into a barrel section of a CH-46E helicopter. A vertical drop test of the barrel section was conducted onto concrete to evaluate the performance of the energy absorbers prior to retrofit into TRACT 2. The retrofitted airframe was crash tested under combined forward and vertical velocity conditions onto soft soil. Finite element models were developed of all test articles and simulations were performed using LS-DYNA, a commercial nonlinear explicit transient dynamic finite element code. Test-analysis results are presented for each energy absorber as comparisons of time-history responses, as well as predicted and experimental structural deformations and progressive damage under impact loading for each evaluation level.

  2. Two-year outcomes in initial survivors with acute liver failure: results from a prospective, multicentre study.

    PubMed

    Fontana, Robert J; Ellerbe, Caitlyn; Durkalski, Valerie E; Rangnekar, Amol; Reddy, Rajender K; Stravitz, Todd; McGuire, Brendan; Davern, Timothy; Reuben, Adrian; Liou, Iris; Fix, Oren; Ganger, Daniel R; Chung, Raymond T; Schilsky, Mike; Han, Steven; Hynan, Linda S; Sanders, Corron; Lee, William M

    2015-02-01

    The long-term clinical outcomes in initial survivors with acute liver failure (ALF) are not well known. The aim of this study was to provide an overview of the 2-year clinical outcomes among initial survivors and liver transplant (LT) recipients that were alive 3 weeks after enrolment in the Acute Liver Failure Study Group (ALFSG). Outcomes in adult ALFSG patients that were enrolled between 1998 and 2010 were reviewed. Two-year patient survival was significantly higher in the 262 LT recipients (92.4%) compared to the 306 acetaminophen (APAP) spontaneous survivors (SS) (89.5%) and 200 non-APAP SS (75.5%) (P < 0.0001). The causes of death were similar in the three groups but the time to death was significantly longer in the LT recipients (P < 0.0001). Independent predictors of 2-year mortality in the APAP group were a high serum phosphate level and patient age (c-statistic = 0.65 (0.54, 0.76)), patient age and days from jaundice to ALF onset in the non-APAP group (c-statistic = 0.69 (0.60, 0.78)), and patient age, days from jaundice, and higher coma grade in the LT recipients (c-statistic = 0.74 (0.61, 0.87)). The LT recipients were significantly more likely to be employed and have a higher educational level (P < 0.05). Two-year outcomes in initial survivors of ALF are generally good but non-APAP patients have a significantly lower survival which may relate to pre-existing medical comorbidities. Spontaneous survivors with APAP overdose experience substantial morbidity during follow-up from ongoing psychiatric and substance abuse issues. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  3. The temporal outcomes of open versus arthroscopic knotted and knotless rotator cuff repair over 5 years

    PubMed Central

    Lucena, Thomas R; Lam, Patrick H; Millar, Neal L

    2015-01-01

    Background The present study aimed to determine how repair technique influenced structural and clinical outcomes at 5 years post-surgery. Methods Three cohorts of patients had repair of a symptomatic rotator cuff tear using (i) an open double-row mattress repair technique (n = 25); (ii) arthroscopic single-row simple suture knotted technique (n = 25); or (iii) arthroscopic single-row inverted mattress knotless technique (n = 36) by one surgeon. Standardized patient- and examiner-determined outcomes were obtained pre-operatively and postoperatively with a validated protocol, ultrasound were also performed at the same time. Results Retear occurred more often after open repair (48%) at 5 years than after arthroscopic knotted (33%) and arthroscopic knotless (26%) repair. Retear was associated with increasing age, pre-operative tear size and weaker pre-operative and 5 years postoperative cuff strength. Between 2 years and 5 years, the open repair group experienced an increase in the frequency of pain during activity, as well as in the difficulty experienced and the severity of pain during overhead activities (p < 0.05) and, at 5 years, also experienced more difficulty with overhead activities, compared to the arthroscopic knotless repair group. Conclusions At 5-year follow-up, arthroscopic rotator cuff repair techniques resulted in fewer retears and better outcomes compared to an open double-row technique. PMID:27582985

  4. Absorbing Software Testing into the Scrum Method

    NASA Astrophysics Data System (ADS)

    Tuomikoski, Janne; Tervonen, Ilkka

    In this paper we study, how to absorb software testing into the Scrum method. We conducted the research as an action research during the years 2007-2008 with three iterations. The result showed that testing can and even should be absorbed to the Scrum method. The testing team was merged into the Scrum teams. The teams can now deliver better working software in a shorter time, because testing keeps track of the progress of the development. Also the team spirit is higher, because the Scrum team members are committed to the same goal. The biggest change from test manager’s point of view was the organized Product Owner Team. Test manager don’t have testing team anymore, and in the future all the testing tasks have to be assigned through the Product Backlog.

  5. Association Between Early Low-Dose Hydrocortisone Therapy in Extremely Preterm Neonates and Neurodevelopmental Outcomes at 2 Years of Age.

    PubMed

    Baud, Olivier; Trousson, Clémence; Biran, Valérie; Leroy, Emilie; Mohamed, Damir; Alberti, Corinne

    2017-04-04

    Dexamethasone to prevent bronchopulmonary dysplasia in very preterm neonates was associated with adverse neurodevelopmental events. Early low-dose hydrocortisone treatment has been reported to improve survival without bronchopulmonary dysplasia but its safety with regard to neurodevelopment remains to be assessed. To assess whether early hydrocortisone therapy in extremely preterm infants is associated with neurodevelopmental impairment at 2 years of age. An exploratory secondary analysis of the PREMILOC (Early Low-Dose Hydrocortisone to Improve Survival without Bronchopulmonary Dysplasia in Extremely Preterm Infants) randomized clinical trial conducted between 2008 and 2014 in 21 French neonatal intensive care units. Randomization was stratified by gestational age groups. Neurodevelopmental assessments were completed from 2010 to 2016. After birth, patients were randomly assigned to receive placebo or hydrocortisone (0.5 mg/kg twice per day for 7 days, followed by 0.5 mg/kg per day for 3 days). The prespecified exploratory secondary outcome of neurodevelopmental impairment was based on a standardized neurological examination and the revised Brunet-Lézine scale (global developmental quotient score and subscores; mean norm, 100 [SD, 15]). The minimal clinically important difference on the global developmental quotient was 5 points. Of 1072 neonates screened, 523 were assigned to hydrocortisone (n = 256) or placebo (n = 267) and 406 survived to 2 years of age. A total of 379 patients (93%; 46% female) were evaluated (194 in the hydrocortisone group and 185 in the placebo group) at a median corrected age of 22 months (interquartile range, 21-23 months). The distribution of patients without neurodevelopmental impairment (73% in the hydrocortisone group vs 70% in the placebo group), with mild neurodevelopmental impairment (20% in the hydrocortisone group vs 18% in the placebo group), or with moderate to severe neurodevelopmental impairment (7% in the

  6. Auckland Stroke Outcomes Study. Part 1: Gender, stroke types, ethnicity, and functional outcomes 5 years poststroke.

    PubMed

    Feigin, V L; Barker-Collo, S; Parag, V; Senior, H; Lawes, C M M; Ratnasabapathy, Y; Glen, E

    2010-11-02

    Studying long-term stroke outcomes including body functioning (neurologic and neuropsychological impairments) and activity limitations and participation is essential for long-term evidence-based rehabilitation and service planning, resource allocation, and improving health outcomes in stroke. However, reliable data to address these issues is lacking. This study (February 2007-December 2008) sourced its participants from the population-based incidence study conducted in Auckland in 2002-2003. Participants completed structured self-administered questionnaires, and a face-to-face interview including a battery of neuropsychological tests. Logistic regression analysis was used to analyze associations between and within functional outcomes and their potential predictors. Of 418 5-year stroke survivors, two-thirds had good functional outcome in terms of neurologic impairment and disability (defined as modified Rankin Score <3), 22.5% had cognitive impairment indicative of dementia, 20% had experienced a recurrent stroke, almost 15% were institutionalized, and 29.6% had symptoms suggesting depression. Highly significant correlations were found between and within various measurements of body functioning (especially neuropsychological impairments), activity, and participation. Age, dependency, and depression were independently associated with most outcomes analyzed. The strong associations between neuropsychological impairment and other functional outcomes and across various measurements of body functioning, activity, and participation justify utilizing a multidisciplinary approach to studying and managing long-term stroke outcomes. Observed gender and ethnic differences in some important stroke outcomes warrant further investigations.

  7. Belgian Schizophrenia Outcome Survey - results of a 2-year naturalistic study in patients stabilised on monotherapy with olanzapine, risperidone or haloperidol.

    PubMed

    Peuskens, J; Gillain, B; De Graeve, D; Van Vleymen, B; Albert, A

    2009-04-01

    This Schizophrenia Outcome Survey compared medical costs, psychopathology and adverse events in outpatients for 2 years following hospitalisation for an acute schizophrenic episode. Adults stabilised with haloperidol, olanzapine or risperidone entered this observational study year, took more corrective and psychotropic drugs and had more extrapyramidal symptoms (EPS) and gynaecomastia (all significantly). Sixty-eight percent of patients completed a 2-year follow-up. In all groups, CGI and GAF improved during the first 3 months (both p<0.0001) while BPRS deteriorated in the first year (all within group changes p<0.05, between group changes NS) before it stabilised. There were no significant differences in hospitalisations and no change in social profile. At the last visit, 66% of haloperidol (p<0.01), 35% of olanzapine (NS) and 39% (NS) of risperidone patients had >or=1 EPS; 69% (p<0.013), 40 and 44%, respectively, had >or=1 sexual problem (NS). Mean weight gain was 0.4 (NS), 2.6 (p<0.05) and 2.6 kg (p<0.05), respectively. In this naturalistic study, treatment allocation might have introduced a bias in the interpretation of efficiency results, but olanzapine and risperidone caused less EPS than haloperidol during 2 years of outpatient follow-up.

  8. Advanced neutron absorber materials

    DOEpatents

    Branagan, Daniel J.; Smolik, Galen R.

    2000-01-01

    A neutron absorbing material and method utilizing rare earth elements such as gadolinium, europium and samarium to form metallic glasses and/or noble base nano/microcrystalline materials, the neutron absorbing material having a combination of superior neutron capture cross sections coupled with enhanced resistance to corrosion, oxidation and leaching.

  9. Graves' disease radioiodine-therapy: Choosing target absorbed doses for therapy planning

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Willegaignon, J., E-mail: j.willegaignon@gmail.com; Sapienza, M. T.; Coura-Filho, G. B.

    2014-01-15

    Purpose: The precise determination of organ mass (m{sub th}) and total number of disintegrations within the thyroid gland (A{sup ~}) are essential for thyroid absorbed-dose calculations for radioiodine therapy. Nevertheless, these parameters may vary according to the method employed for their estimation, thus introducing uncertainty in the estimated thyroid absorbed dose and in any dose–response relationship derived using such estimates. In consideration of these points, thyroid absorbed doses for Graves’ disease (GD) treatment planning were calculated using different approaches to estimating the m{sub th} and the A{sup ~}. Methods: Fifty patients were included in the study. Thyroid{sup 131}I uptake measurementsmore » were performed at 2, 6, 24, 48, 96, and 220 h postadministration of a tracer activity in order to estimate the effective half-time (T{sub eff}) of {sup 131}I in the thyroid; the thyroid cumulated activity was then estimated using the T{sub eff} thus determined or, alternatively, calculated by numeric integration of the measured time-activity data. Thyroid mass was estimated by ultrasonography (USG) and scintigraphy (SCTG). Absorbed doses were calculated with the OLINDA/EXM software. The relationships between thyroid absorbed dose and therapy response were evaluated at 3 months and 1 year after therapy. Results: The average ratio (±1 standard deviation) betweenm{sub th} estimated by SCTG and USG was 1.74 (±0.64) and that between A{sup ~} obtained by T{sub eff} and the integration of measured activity in the gland was 1.71 (±0.14). These differences affect the calculated absorbed dose. Overall, therapeutic success, corresponding to induction of durable hypothyroidism or euthyroidism, was achieved in 72% of all patients at 3 months and in 90% at 1 year. A therapeutic success rate of at least 95% was found in the group of patients receiving doses of 200 Gy (p = 0.0483) and 330 Gy (p = 0.0131) when m{sub th} was measured by either USG or SCTG

  10. Graves' disease radioiodine-therapy: Choosing target absorbed doses for therapy planning

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Willegaignon, J., E-mail: j.willegaignon@gmail.com; Sapienza, M. T.; Coura-Filho, G. B.

    Purpose: The precise determination of organ mass (m{sub th}) and total number of disintegrations within the thyroid gland (A{sup ~}) are essential for thyroid absorbed-dose calculations for radioiodine therapy. Nevertheless, these parameters may vary according to the method employed for their estimation, thus introducing uncertainty in the estimated thyroid absorbed dose and in any dose–response relationship derived using such estimates. In consideration of these points, thyroid absorbed doses for Graves’ disease (GD) treatment planning were calculated using different approaches to estimating the m{sub th} and the A{sup ~}. Methods: Fifty patients were included in the study. Thyroid{sup 131}I uptake measurementsmore » were performed at 2, 6, 24, 48, 96, and 220 h postadministration of a tracer activity in order to estimate the effective half-time (T{sub eff}) of {sup 131}I in the thyroid; the thyroid cumulated activity was then estimated using the T{sub eff} thus determined or, alternatively, calculated by numeric integration of the measured time-activity data. Thyroid mass was estimated by ultrasonography (USG) and scintigraphy (SCTG). Absorbed doses were calculated with the OLINDA/EXM software. The relationships between thyroid absorbed dose and therapy response were evaluated at 3 months and 1 year after therapy. Results: The average ratio (±1 standard deviation) betweenm{sub th} estimated by SCTG and USG was 1.74 (±0.64) and that between A{sup ~} obtained by T{sub eff} and the integration of measured activity in the gland was 1.71 (±0.14). These differences affect the calculated absorbed dose. Overall, therapeutic success, corresponding to induction of durable hypothyroidism or euthyroidism, was achieved in 72% of all patients at 3 months and in 90% at 1 year. A therapeutic success rate of at least 95% was found in the group of patients receiving doses of 200 Gy (p = 0.0483) and 330 Gy (p = 0.0131) when m{sub th} was measured by either USG or SCTG

  11. All-Inside, All-Epiphyseal Anterior Cruciate Ligament Reconstruction in Skeletally Immature Athletes: Return to Sport, Incidence of Second Surgery, and 2-Year Clinical Outcomes.

    PubMed

    Cordasco, Frank A; Mayer, Stephanie Watson; Green, Daniel W

    2017-03-01

    Anterior cruciate ligament (ACL) injuries in skeletally immature athletes are increasing. To evaluate the 2-year clinical outcomes of all-inside, all-epiphyseal ACL reconstruction in skeletally immature athletes with 3 to 6 years of remaining growth, with a focus on return to sport and the incidence of second surgery. Case series; Level of evidence, 4. Twenty-three skeletally immature athletes were prospectively evaluated after all-epiphyseal ACL reconstruction utilizing a hamstring autograft. The athletes' age, sex, sport, mechanism of injury, radiographs, and magnetic resonance imaging (MRI) findings were noted. The evaluation included a physical examination, KT-1000 arthrometer measurements, isokinetic testing, and validated outcome scores. Standing radiographs and spoiled gradient recalled echo MRI scans were obtained at 6, 12, and 24 months postoperatively. A quality of movement assessment and return-to-sport performance analysis were also performed. Of the 23 athletes, 6 were female (mean age, 11.3 years), and 17 were male (mean age, 12.6 years). At a minimum follow-up of 2 years (range, 24-45 months), the mean International Knee Documentation Committee score was 94.6 ± 4.9, the mean Lysholm score was 97.9 ± 4.0, the mean Marx activity rating scale score was 13.4 ± 3.6, and the mean Hospital for Special Surgery Pediatric Functional Activity Brief Scale score was 23.9 ± 7.0. Lachman and pivot-shift test results were negative in all patients. The mean side-to-side difference on the KT-1000 arthrometer was 0.9 ± 0.5 mm and less tight on the operated side. No significant growth disturbances were noted; however, 6 athletes had a leg-length discrepancy of more than 5 mm (range, 6-18 mm). Two patients had overgrowth in the femur of more than 15 mm (16 mm and 18 mm). Two athletes (8.7%) required second surgery. The mean time to return to unrestricted activity was 13.5 months (range, 8-22 months). The all-inside, all-epiphyseal ACL reconstruction technique using

  12. Triplet-triplet energy transfer from a UV-A absorber butylmethoxydibenzoylmethane to UV-B absorbers.

    PubMed

    Kikuchi, Azusa; Oguchi-Fujiyama, Nozomi; Miyazawa, Kazuyuki; Yagi, Mikio

    2014-01-01

    The phosphorescence decay of a UV-A absorber, 4-tert-butyl-4'-methoxydibenzolymethane (BMDBM) has been observed following a 355 nm laser excitation in the absence and presence of UV-B absorbers, 2-ethylhexyl 4-methoxycinnamate (octyl methoxycinnamate, OMC) and octocrylene (OCR) in ethanol at 77 K. The lifetime of the lowest excited triplet (T1) state of BMDBM is significantly reduced in the presence of OMC and OCR. The observed quenching of BMDBM triplet by OMC and OCR suggests that the intermolecular triplet-triplet energy transfer occurs from BMDBM to OMC and OCR. The T1 state of OCR is nonphosphorescent or very weakly phosphorescent. However, we have shown that the energy level of the T1 state of OCR is lower than that of the enol form of BMDBM. Our methodology of energy-donor phosphorescence decay measurements can be applied to the study of the triplet-triplet energy transfer between UV absorbers even if the energy acceptor is nonphosphorescent. In addition, the delayed fluorescence of BMDBM due to triplet-triplet annihilation was observed in the BMDBM-OMC and BMDBM-OCR mixtures in ethanol at 77 K. Delayed fluorescence is one of the deactivation processes of the excited states of BMDBM under our experimental conditions. © 2013 The American Society of Photobiology.

  13. Transcatheter aortic valve implantation using the ACURATE TA™ system: 1-year outcomes and comparison of 500 patients from the SAVI registries.

    PubMed

    Börgermann, Jochen; Holzhey, David M; Thielmann, Matthias; Girdauskas, Evaldas; Schroefel, Holger; Hofmann, Steffen; Treede, Hendrik; Matschke, Klaus; Hilker, Michael; Strauch, Justus T; Carrel, Thierry; Wahlers, Thorsten; Diegeler, Anno; Kempfert, Jörg; Walther, Thomas

    2017-05-01

    The ACURATE TA TM system is a self-expanding transcatheter heart valve system designed for transapical access which has been proven to be safe and effective in the controlled setting of clinical trials. The SAVI-1 and SAVI-2 registries aimed to assess whether these promising outcomes can be translated into all-comers clinical routine. From November 2011 to 2012 (SAVI-1), and November 2013 to 2014 (SAVI-2), a total of 500 patients were enrolled in the prospective, all-comers, multicentre, multinational SAVI registries. Patients were treated according to the standard of care at their respective hospitals. We report and compare 30-day and 1-year clinical outcomes between SAVI-1 and -2. Patients were 80.8 ± 6.1 years old, the mean logistic EuroSCORE-I was 23.4 ± 14.3%. Valves were deployed under rapid pacing in 71.3% of the procedures in SAVI-1, and in 3.6% in SAVI-2. There was no relevant difference in clinical and echocardiographic outcomes between SAVI-1 and SAVI-2. Overall mortality at 30 days and 1 year was 6.8% and 19.9%, the stroke rate was 2.2% and 3.7%, respectively; 10.2% of patients had received a permanent pacemaker, and no transcatheter valve-related complications after discharge were observed. Paravalvular leakage ≥2+ was reported in 1.9% of the patients at the early follow-up, and in 2.6% at the 1-year follow-up. The SAVI-registries have confirmed that transapical implantation using the ACURATE TA TM device is safe and effective in an all-comers setting with low complication rates and stable performance outcomes at short-term and 1 year; outcomes were similar between SAVI-1 and -2. © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery.

  14. A Comparison of Four-Year Health Outcomes following Combat Amputation and Limb Salvage

    PubMed Central

    Walker, Jay; Bhatnagar, Vibha; Richard, Erin; Sechriest, V. Franklin; Galarneau, Michael

    2017-01-01

    Little research has described the long-term health outcomes of patients who had combat-related amputations or leg-threatening injuries. We conducted retrospective analysis of Department of Defense and Department of Veterans Affairs health data for lower extremity combat-injured patients with (1) unilateral amputation within 90 days postinjury (early amputation, n = 440), (2) unilateral amputation more than 90 days postinjury (late amputation, n = 78), or (3) leg-threatening injuries without amputation (limb salvage, n = 107). Patient medical records were analyzed for four years postinjury. After adjusting for group differences, early amputation was generally associated with a lower or similar prevalence for adverse physical and psychological diagnoses (e.g., pain, osteoarthritis, posttraumatic stress disorder) versus late amputation and/or limb salvage. By contrast, early amputation was associated with an increased likelihood of osteoporosis during the first year postinjury. The prevalence of posttraumatic stress disorder increased for all patient groups over four years postinjury, particularly in the second year. The different clinical outcomes among combat extremity injured patients treated with early amputation, late amputation, or limb salvage highlight their different healthcare requirements. These findings can inform and optimize the specific treatment pathways that address the physical and psychological healthcare needs of such patients over time. PMID:28122002

  15. Neurocognition and functional outcome in early-onset schizophrenia and attention-deficit/hyperactivity disorder: a 13-year follow-up.

    PubMed

    Oie, Merete; Sundet, Kjetil; Ueland, Torill

    2011-01-01

    The relation between neurocognitive impairments and functional outcome has been documented in both early onset schizophrenia (EOS) and attention-deficit/hyperactivity disorder (ADHD), but less is known about the long-term relation between these factors. The present study investigates how neurocognition at baseline is related to measures of functional outcome at 13-year follow-up in subjects with EOS and ADHD. Subjects with EOS (n = 15), ADHD (n = 19), and healthy controls (n = 30) were followed up 13 years after initial assessment. All subjects were between 12 and 18 years of age at baseline and between 24 and 30 at follow-up. They were retested at T2 with the same comprehensive neurocognitive test battery as used at T1, and reassessed with various symptom and behavior ratings and functional outcome measures. Both groups were characterized by reduced functional outcome at follow-up, although of different magnitude and type, compared with healthy controls. In the EOS group, neurocognitive baseline measures were associated with social functioning at follow-up (η2 between .26 and .41), while for the ADHD group, no significant predictions were found. Adolescents with EOS and ADHD are characterized by poor functional outcome compared with healthy controls when reassessed as young adults. Executive function, memory and attention were related to social and community functioning in EOS. For ADHD no significant predictions were found although functional outcome was poor. For both groups treatment should focus on training of social skills and activities of daily living to enhance the long-term functional outcome. For EOS cognitive remediation should also be considered. (c) 2010 APA, all rights reserved.

  16. Uncertainty analysis for absorbed dose from a brain receptor imaging agent

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Aydogan, B.; Miller, L.F.; Sparks, R.B.

    Absorbed dose estimates are known to contain uncertainties. A recent literature search indicates that prior to this study no rigorous investigation of uncertainty associated with absorbed dose has been undertaken. A method of uncertainty analysis for absorbed dose calculations has been developed and implemented for the brain receptor imaging agent {sup 123}I-IPT. The two major sources of uncertainty considered were the uncertainty associated with the determination of residence time and that associated with the determination of the S values. There are many sources of uncertainty in the determination of the S values, but only the inter-patient organ mass variation wasmore » considered in this work. The absorbed dose uncertainties were determined for lung, liver, heart and brain. Ninety-five percent confidence intervals of the organ absorbed dose distributions for each patient and for a seven-patient population group were determined by the ``Latin Hypercube Sampling`` method. For an individual patient, the upper bound of the 95% confidence interval of the absorbed dose was found to be about 2.5 times larger than the estimated mean absorbed dose. For the seven-patient population the upper bound of the 95% confidence interval of the absorbed dose distribution was around 45% more than the estimated population mean. For example, the 95% confidence interval of the population liver dose distribution was found to be between 1.49E+0.7 Gy/MBq and 4.65E+07 Gy/MBq with a mean of 2.52E+07 Gy/MBq. This study concluded that patients in a population receiving {sup 123}I-IPT could receive absorbed doses as much as twice as large as the standard estimated absorbed dose due to these uncertainties.« less

  17. Neurodevelopmental and cardiometabolic outcome in 4-year-old twins and singletons born after IVF.

    PubMed

    Kuiper, Derk; Bennema, Anne; la Bastide-van Gemert, Sacha; Seggers, Jorien; Schendelaar, Pamela; Haadsma, Maaike; Hoek, Annemieke; Heineman, Maas-Jan; Hadders-Algra, Mijna

    2017-06-01

    This prospective cohort study evaluated whether the cognitive development, neurological condition, anthropometrics and blood pressure of 4-year-old IVF twins differed from those of 4-year-old IVF singletons; 103 IVF singletons and 48 IVF twins born after conventional IVF treatment were included. Primary outcome was total intelligence quotient (IQ). Secondary outcomes were minor neurological dysfunction, anthropometrics and blood pressure. Unadjusted analyses found that the total IQ score of twins was lower than that of singletons, with a mean difference of -5.4 (-9.7 to -1.0). Weight (singletons: 18.6 [18.1 to 19.1] kg; twins: 16.9 [16.0 to 17.9] kg) and height (singletons: 108.8 [107.9 to 109.8] cm; twins: 105.9 [104.0 to 107.7] cm) of twins were lower than those of singletons (mean values [95% CI]). All differences disappeared after adjusting for mediators and confounders. Neurological outcome, systolic and diastolic blood pressure of twins and singletons were similar. Four-year-old IVF twins had a lower total IQ (-5.4 points), lowerbodyweight (-1.7 kg) and were shorter (-2.9 cm) than 4-year-old IVF singletons. After adjustment, the adverse twin effect disappeared, implying that increased risk for impaired health and development in twins also holds true for IVF twins, and is not altered by IVF. Copyright © 2017 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  18. Design and testing of an energy-absorbing crewseat for the F/FB-111 aircraft. Volume 2: Data from seat testing

    NASA Technical Reports Server (NTRS)

    Shane, S. J.

    1985-01-01

    The unacceptably high injury rate during the escape sequence (including the ejection and ground impact) of the crew module for F/FB-111 aircraft is reviewed. A program to determine if the injury potential could be reduced by replacing the existing crewseats with energy absorbing crewseats is presented. An energy absorbing test seat is designed using much of the existing seat hardware. An extensive dynamic seat test series, designed to duplicate various crew module ground impact conditions is conducted at a sled test facility. Comparative tests with operational F-111 crewseats are also conducted. After successful dynamic testing of the seat, more testing is conducted with the seats mounted in an F-111 crew module. Both swing tests and vertical drop tests are conducted. The vertical drop tests are used to obtain comparative data between the energy absorbing and operational seats. Volume 1 describes the energy absorbing test seat and testing conducted, and evaluates the data from both test series. Volume 2 presents the data obtained during the seat test series, while Volume 3 presents the data from the crew module test series.

  19. Solar radiation absorbing material

    DOEpatents

    Googin, John M.; Schmitt, Charles R.; Schreyer, James M.; Whitehead, Harlan D.

    1977-01-01

    Solar energy absorbing means in solar collectors are provided by a solar selective carbon surface. A solar selective carbon surface is a microporous carbon surface having pores within the range of 0.2 to 2 micrometers. Such a surface is provided in a microporous carbon article by controlling the pore size. A thermally conductive substrate is provided with a solar selective surface by adhering an array of carbon particles in a suitable binder to the substrate, a majority of said particles having diameters within the range of about 0.2-10 microns.

  20. Electromagnetic wave absorbing properties of amorphous carbon nanotubes.

    PubMed

    Zhao, Tingkai; Hou, Cuilin; Zhang, Hongyan; Zhu, Ruoxing; She, Shengfei; Wang, Jungao; Li, Tiehu; Liu, Zhifu; Wei, Bingqing

    2014-07-10

    Amorphous carbon nanotubes (ACNTs) with diameters in the range of 7-50 nm were used as absorber materials for electromagnetic waves. The electromagnetic wave absorbing composite films were prepared by a dip-coating method using a uniform mixture of rare earth lanthanum nitrate doped ACNTs and polyvinyl chloride (PVC). The microstructures of ACNTs and ACNT/PVC composites were characterized using transmission electron microscope and X-ray diffraction, and their electromagnetic wave absorbing properties were measured using a vector-network analyzer. The experimental results indicated that the electromagnetic wave absorbing properties of ACNTs are superior to multi-walled CNTs, and greatly improved by doping 6 wt% lanthanum nitrate. The reflection loss (R) value of a lanthanum nitrate doped ACNT/PVC composite was -25.02 dB at 14.44 GHz, and the frequency bandwidth corresponding to the reflector loss at -10 dB was up to 5.8 GHz within the frequency range of 2-18 GHz.

  1. Long-term outcome of patients with dysthymia and panic disorder: a naturalistic 9-year follow-up study.

    PubMed

    Svanborg, Cecilia; Wistedt, Anna Aberg; Svanborg, Pär

    2008-01-01

    The highly prevalent psychiatric disorders dysthymia and panic disorder have often a chronic or recurrent course with superimposed major depression. The prominent comorbidity between these diagnoses constitutes a confounding factor in the study of long-term outcome. We performed a 9-year follow-up of 38 patients with "pure" diagnoses, i.e. without comorbid dysthymia and panic disorder, selected from two 2-year naturalistic treatment studies with psychotherapy and antidepressant medication. The aims of the present study were to investigate 1) the stability of change, and 2) the impact of comorbid personality disorders (PDs) on long-term outcome. Patients were reassessed with SCID-I and SCID-II interviews, SCL-90/BSI and a detailed, modified life-charting interview, investigating course and treatment over time. About 50% of patients showed substantial improvement, of whom about half were in remission. Comorbid PD was a negative prognostic factor independently of Axis I diagnosis. Although patients with panic disorder had a lower frequency of comorbid PD, later onset, shorter duration of illness and better outcome after the original studies, there was no difference in the long-term outcome. The less stable outcome among panic patients suggests that standard treatments are not resulting in enduring remission. In order to achieve remission, it is necessary to 1) address comorbid PDs, 2) perform careful assessments of all comorbid diagnoses, and 3) build routines for the follow-up and augmentation of treatments.

  2. Severity and outcomes according to stroke etiology in patients under 50 years of age with ischemic stroke.

    PubMed

    Prefasi, Daniel; Martínez-Sánchez, Patricia; Fuentes, Blanca; Díez-Tejedor, Exuperio

    2016-08-01

    To analyze the association of stroke etiological subtypes with severity and outcomes at 3 and 12 months in patients ≤50 years. Observational study of patients admitted to a stroke unit (2007-2013). demographic data, vascular risk factors, comorbidities, severity on admission (NIHSS), and good functional outcome (mRS ≤ 1) at 3 and 12 months. We used multivariate analyses to evaluate the influence of stroke etiology on severity and outcomes. We included 214 patients, 58.3 % men, mean age 41.4 years. General linear models showed all etiologies were more severe than lacunar strokes (P < 0.05). Atherothrombotic strokes showed greater severity than those of undetermined and uncommon etiology, whereas cardioembolic strokes were more severe than cryptogenic. Taking into account specific etiologies, atherothrombotic strokes (B = 5.860; 95 % CI 2.979-8.751), cervical artery dissection (CAD) [B = 7.485; 95 % confidence interval (CI) 4.734-10.237], and atrial fibrillation (AF) strokes (B = 5.773; 95 % CI 2.704-8.132) were more severe than other etiologies. Logistic regression models showed that strokes of uncommon etiology, especially those not related to CAD, had a lower probability of good outcome at 3 months [odds ratio (OR) = 0.197; CI 95 % 0.044-0.873], whereas atherothrombotic strokes were associated with this probability at 12 months (OR = 0.187; 95 % CI 0.037-0.951; P = 0.007). In patients ≤50 years of age, strokes of atherothrombotic, cardioembolic (particularly those due to AF), and uncommon etiology had a greater severity than the rest. Furthermore, strokes of uncommon etiology, especially those different from CAD, decreased the probability of a good outcome at 3 months, as did atherothrombotic strokes at 1 year.

  3. Superlattice photonic crystal as broadband solar absorber for high temperature operation.

    PubMed

    Rinnerbauer, Veronika; Shen, Yichen; Joannopoulos, John D; Soljačić, Marin; Schäffler, Friedrich; Celanovic, Ivan

    2014-12-15

    A high performance solar absorber using a 2D tantalum superlattice photonic crystal (PhC) is proposed and its design is optimized for high-temperature energy conversion. In contrast to the simple lattice PhC, which is limited by diffraction in the short wavelength range, the superlattice PhC achieves solar absorption over broadband spectral range due to the contribution from two superposed lattices with different cavity radii. The superlattice PhC geometry is tailored to achieve maximum thermal transfer efficiency for a low concentration system of 250 suns at 1500 K reaching 85.0% solar absorptivity. In the high concentration case of 1000 suns, the superlattice PhC absorber achieves a solar absorptivity of 96.2% and a thermal transfer efficiency of 82.9% at 1500 K, amounting to an improvement of 10% and 5%, respectively, versus the simple square lattice PhC absorber. In addition, the performance of the superlattice PhC absorber is studied in a solar thermophotovoltaic system which is optimized to minimize absorber re-emission by reducing the absorber-to-emitter area ratio and using a highly reflective silver aperture.

  4. Long term (7 or more years) outcomes of the sleeve gastrectomy: a meta-analysis.

    PubMed

    Clapp, Benjamin; Wynn, Matthew; Martyn, Colin; Foster, Chase; O'Dell, Montana; Tyroch, Alan

    2018-03-06

    The laparoscopic sleeve gastrectomy is now the most common bariatric operation in the United States and has become an established procedure in the armamentarium of the bariatric surgeon. However, this has happened without the strong support of long-term outcomes data, namely the rate of revision and durability of the weight loss. Newly published data from around the world are starting to show alarming trends in these 2 areas. This paper will examine the published and presented data with at least a 7-year follow-up. This is a meta-analysis on published data with at least 7 years of follow-up from the laparoscopic sleeve gastrectomy. Online published articles. We performed a meta-analysis of publications with at least 7 years of follow-up with the keywords "laparoscopic, bariatric, sleeve gastrectomy, sleeve, long-term, long, term, results, follow-up, follow up, conversion, 7 years, 8 years, 9 years, 10 years, 11 years." We queried the PubMed, MEDLINE, and ClinicalKey search engines, which included abstracts as well. The I 2 statistic was used to determine the heterogeneity across the studies. In presence of heterogeneity, a random effect model using the Dersimonian and Laird method was used to estimate the pooled estimates. The results were summarized using effect size along with a 95% confidence interval (CI). Meta-regression was also used to assess the effect of body mass index and follow-up years on the incidence of recidivism at ≥7 years. Nine cohort studies met the inclusion criteria, with a total of 2280 patients included initially. Only 652 patients had completed ≥7 years of follow-up. At ≥7 years, the long-term weight recidivism rate was estimated to be 27.8% (I 2 = .60%; 95% CI: 22.8%-32.7%) with a range of 14% to 37%. The overall revision rate was estimated to be 19.9% (I 2 = 93.8%; 95% CI: 11.3%-28.5%). This was broken down into 13.1% (I 2 = 93.8%; 95% CI: 5.6%-20.6%) due to weight regain (5 studies) and 2.9% (I 2 = 60.8%; 95% CI: 1%-4.9%) due to

  5. Nine-year outcome after anatomic stemless shoulder prosthesis: clinical and radiologic results.

    PubMed

    Hawi, Nael; Magosch, Petra; Tauber, Mark; Lichtenberg, Sven; Habermeyer, Peter

    2017-09-01

    Several stemless shoulder implants are available on the market, but only a few studies have presented results with sufficient mid- to long-term follow-up. The present study evaluated clinical and radiologic outcomes 9 years after anatomic stemless shoulder replacement. This is a prospective cohort study evaluating the stemless shoulder prosthesis since 2005. Anatomic stemless shoulder replacement using a single prosthesis was performed in 49 shoulders; 17 underwent total shoulder replacement, and 32 underwent hemiarthroplasty. Forty-three patients were clinically and radiologically monitored after a mean of 9 years (range, 90-127 months; follow-up rate, 88%). The indications for shoulder replacement were primary osteoarthritis in 7 shoulders, post-traumatic in 24, instability in 7, cuff tear arthropathy in 2, postinfectious arthritis in 1, and revision arthroplasty in 2. The Constant-Murley Score improved significantly from 52% to 79% (P < .0001). The active range of motion also increased significantly for flexion from 101° to 118° (P = .022), for abduction from 79° to 105° (P = .02), and for external rotation from 21° to 43° (P < .0001). Radiologic evaluation revealed incomplete radiolucency in 1 patient without clinical significance or further intervention. No revision caused by loosening or countersinking of the humeral implant was observed. The 9-year outcome after stemless shoulder replacement is comparable to that of third- and fourth-generation standard shoulder arthroplasty. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  6. Light Absorbing Particle (LAP) Measurements in the Lower Stratosphere

    NASA Technical Reports Server (NTRS)

    Baumgardner, D.; Raga, G. B.; Anderson, B.; Diskin, G.; Sachse, G.; Kok, G.

    2003-01-01

    This viewgraph presentation covers the capabilities and design of the Single Particle Soot Photometer (SP-2), and reviews its role on the Sage III Ozone Loss Validation Experiment (SOLVE II) field campaign during 2003. On SOLVE II the SP-2 was carried into the Arctic onboard a DC-8 aircraft, in order to determine the size distribution of light-absorbing and non light-absorbing particles in the stratosphere. Graphs and tables relate some of the results from SOLVE II.

  7. Outcome of lupus nephritis in childhood onset SLE in North and Central India: single-centre experience over 25 years.

    PubMed

    Srivastava, P; Abujam, B; Misra, R; Lawrence, A; Agarwal, V; Aggarwal, A

    2016-04-01

    Childhood SLE (cSLE) has a higher prevalence of lupus nephritis (LN), and there are ethnic variations in response to treatment as well as outcome of LN. There are limited data on long-term outcome of LN in cSLE from the Indian subcontinent. Retrospective analysis of case records of patients with cSLE (satisfying revised American College of Rheumatology (ACR) 1997 criteria for diagnosis) and age of onset <18 years was conducted from 1989 to 2013. Data on clinical features, renal involvement and biopsy findings, treatment, renal outcome, damage accrual and mortality were collected. End-stage renal disease (ESRD) was defined as the need for renal replacement therapy. Actuarial ESRD-free survival was studied as the primary outcome measure using Kaplan-Meier analysis. Among 205 children with cSLE, 134 (121 girls) had evidence of LN. The mean age at disease onset was 13.7 ± 3.5 years and the mean disease duration at presentation was 1.9 ± 2.5 years. Kidney biopsy was available for 92 patients, and histology included: 13 (14.2%) Class II, 24 (26%) Class III, 43 (46.7%) Class IV and 12 (13.1%) Class V LN. The mean follow-up period was 6.75 ± 5.7 years. At last visit, 81 (60.4%) children were in complete remission, 28 (20.9%) were in partial remission, 15 (11.2%) still had active nephritis and 10 (7.4%) had progressed to ESRD. Almost two-thirds (62.9%) of patients experienced lupus flares, and mean flare rate was 0.09 flares/patient follow-up year. Fifty-six (43.8%) children accrued damage and the mean Systemic Lupus International Collaborating Clinics (SLICC)/ACR damage score was 0.79 ± 1.13. Actuarial ESRD-free survival at five, 10 and 15 years was 91.1%, 79% and 76.2%, and five-, 10- and 15-year renal survival was 93.8%, 87.1% and 84%, respectively. Although multiple factors individually predicted poor outcome (death/ESRD), only raised serum creatinine at onset (R square = 0.65, p ≤ 0.0001) and damage accrual (R square = 0.62, p

  8. Development of 2 underseat energy absorbers for application to crashworthy passenger seats for general aviation aircraft

    NASA Technical Reports Server (NTRS)

    Warrick, J. C.; Desjardins, S. P.

    1979-01-01

    This report presents the methodology and results of a program conducted to develop two underseat energy absorber (E/A) concepts for application to nonadjustable crashworthy passenger seats for general aviation aircraft. One concept utilizes an inflated air bag, and the other, a convoluted sheet metal bellows. Prototypes of both were designed, built, and tested. Both concepts demonstrated the necessary features of an energy absorber (load-limiter); however, the air bag concept is particularly encouraging because of its light weight. Several seat frame concepts also were investigated as a means of resisting longitudinal and lateral loads and of guiding the primary vertical stroke of the underseat energy absorber. Further development of a seat system design using the underseat energy absorbers is recommended because they provide greatly enhanced crash survivability as compared with existing general aviation aircraft seats.

  9. Constraining MHD Disk-Winds with X-ray Absorbers

    NASA Astrophysics Data System (ADS)

    Fukumura, Keigo; Tombesi, F.; Shrader, C. R.; Kazanas, D.; Contopoulos, J.; Behar, E.

    2014-01-01

    From the state-of-the-art spectroscopic observations of active galactic nuclei (AGNs) the robust features of absorption lines (e.g. most notably by H/He-like ions), called warm absorbers (WAs), have been often detected in soft X-rays (< 2 keV). While the identified WAs are often mildly blueshifted to yield line-of-sight velocities up to ~100-3,000 km/sec in typical X-ray-bright Seyfert 1 AGNs, a fraction of Seyfert galaxies such as PG 1211+143 exhibits even faster absorbers (v/ 0.1-0.2) called ultra-fast outflows (UFOs) whose physical condition is much more extreme compared with the WAs. Motivated by these recent X-ray data we show that the magnetically- driven accretion-disk wind model is a plausible scenario to explain the characteristic property of these X-ray absorbers. As a preliminary case study we demonstrate that the wind model parameters (e.g. viewing angle and wind density) can be constrained by data from PG 1211+143 at a statistically significant level with chi-squared spectral analysis. Our wind models can thus be implemented into the standard analysis package, XSPEC, as a table spectrum model for general analysis of X-ray absorbers.

  10. Benchmark Evaluation of the HTR-PROTEUS Absorber Rod Worths (Core 4)

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    John D. Bess; Leland M. Montierth

    2014-06-01

    PROTEUS was a zero-power research reactor at the Paul Scherrer Institute (PSI) in Switzerland. The critical assembly was constructed from a large graphite annulus surrounding a central cylindrical cavity. Various experimental programs were investigated in PROTEUS; during the years 1992 through 1996, it was configured as a pebble-bed reactor and designated HTR-PROTEUS. Various critical configurations were assembled with each accompanied by an assortment of reactor physics experiments including differential and integral absorber rod measurements, kinetics, reaction rate distributions, water ingress effects, and small sample reactivity effects [1]. Four benchmark reports were previously prepared and included in the March 2013 editionmore » of the International Handbook of Evaluated Reactor Physics Benchmark Experiments (IRPhEP Handbook) [2] evaluating eleven critical configurations. A summary of that effort was previously provided [3] and an analysis of absorber rod worth measurements for Cores 9 and 10 have been performed prior to this analysis and included in PROTEUS-GCR-EXP-004 [4]. In the current benchmark effort, absorber rod worths measured for Core Configuration 4, which was the only core with a randomly-packed pebble loading, have been evaluated for inclusion as a revision to the HTR-PROTEUS benchmark report PROTEUS-GCR-EXP-002.« less

  11. Foliage nitrogen turnover: differences among nitrogen absorbed at different times by Quercus serrata saplings

    PubMed Central

    Ueda, Miki U.; Mizumachi, Eri; Tokuchi, Naoko

    2011-01-01

    Background and Aims Nitrogen turnover within plants has been intensively studied to better understand nitrogen use strategies. However, differences among the nitrogen absorbed at different times are not completely understood and the fate of nitrogen absorbed during winter is largely uncharacterized. In the present study, nitrogen absorbed at different times of the year (growing season, winter and previous growing season) was traced, and the within-leaf nitrogen turnover of a temperate deciduous oak Quercus serrata was investigated. Methods The contributions of nitrogen absorbed at the three different times to leaf construction, translocation during the growing season, and the leaf-level resorption efficiency during leaf senescence were compared using 15N. Key Results Winter- and previous growing season-absorbed nitrogen significantly contributed to leaf construction, although the contribution was smaller than that of growing season-absorbed nitrogen. On the other hand, the leaf-level resorption efficiency of winter- and previous growing season-absorbed nitrogen was higher than that of growing season-absorbed nitrogen, suggesting that older nitrogen is better retained in leaves than recently absorbed nitrogen. Conclusions The results demonstrate that nitrogen turnover in leaves varies with nitrogen absorption times. These findings are important for understanding plant nitrogen use strategies and nitrogen cycles in forest ecosystems. PMID:21515608

  12. Neutron absorbers and methods of forming at least a portion of a neutron absorber

    DOEpatents

    Guillen, Donna P; Porter, Douglas L; Swank, W David; Erickson, Arnold W

    2014-12-02

    Methods of forming at least a portion of a neutron absorber include combining a first material and a second material to form a compound, reducing the compound into a plurality of particles, mixing the plurality of particles with a third material, and pressing the mixture of the plurality of particles and the third material. One or more components of neutron absorbers may be formed by such methods. Neutron absorbers may include a composite material including an intermetallic compound comprising hafnium aluminide and a matrix material comprising pure aluminum.

  13. A new hybrid active/passive sound absorber with variable surface impedance

    NASA Astrophysics Data System (ADS)

    Betgen, Benjamin; Galland, Marie-Annick

    2011-07-01

    The context of the present paper is the wall treatment of flow ducts, notably aero-engine nacelle intakes and outlets. For this purpose, hybrid active/passive absorbers have been developed at the LMFA for about 15 years. A hybrid cell combines passive absorbent properties of a porous layer and active control at its rear face. Active control is mainly used to increase absorption at low frequencies by cancelling the imaginary part of the surface impedance presented by the absorber. However, the optimal impedance (i.e. the one that produces the highest noise reduction) of an absorber for flow duct applications is generally complex and frequency dependent. A new hybrid absorber intended to realise any of impedance has therefore been developed. The new cell uses one microphone on each side of a resistive cloth. Normal velocity can then be deduced by a simple pressure difference, which allows an estimation of the surface impedance of the absorber. In order to obtain an error signal related to a target impedance, the target impedance has to be reproduced in time domain. The design of a stable and causal filter is a difficult task, considering the kind of frequency response we seek. An alternative way of representing the impedance in time domain is therefore given. The new error signal is integrated into a feedback control structure. Fast convergence and good stability are observed for a wide range of target impedances. Typical optimal impedances with a positive increasing real part and a negative decreasing imaginary part have been successfully realised. Measurements in a grazing-incidence tube show that the new complex impedance absorber clearly outperforms the former active absorber.

  14. Calcaneocuboid arthrodesis for recurrent clubfeet: what is the outcome at 17-year follow-up?

    PubMed

    Chu, Alice; Chaudhry, Sonia; Sala, Debra A; Atar, Dan; Lehman, Wallace B

    2014-02-01

    Calcaneocuboid arthrodesis was used during revision clubfoot surgery in order to maintain midfoot correction. The purposes of this study were to determine: (1) functional level at 17-year follow-up compared to 5-year follow-up; (2) patients' current functional level, satisfaction, and pain; and (3) current arthropometric measurements. Twenty patients (27 clubfeet) with clubfoot relapse underwent revision soft tissue release and calcaneocuboid fusion between 1991 and 1994. They were previously evaluated at a mean follow-up of 5.5 years. Ten out of 20 patients (13 clubfeet), mean age of 24 years, were reevaluated at mean follow-up of 17.5 years. The Hospital for Joint Diseases Functional Rating System (HJD FRS) for clubfoot surgery, Outcome Evaluation in Clubfoot developed by the International Clubfoot Study Group, the Clubfoot Disease-Specific Instrument, American Academy of Orthopaedic Surgeons (AAOS) Foot and Ankle Outcomes Questionnaire, Laaveg and Ponseti's functional rating system for clubfoot and pain scale were completed by patient and/or surgeon to assess function, patient satisfaction and pain. Foot and ankle radiographs and anthropometric measurements were reviewed. For HJD FRS, scores from original follow-up were compared to current ones. The HJD FRS score of all feet was 65.9, demonstrating a significant decline from the original mean score of 77.8 (p = 0.03). Excellent/good HJD FRS scores went from 85 to 38 %. Mean AAOS Foot Ankle Outcomes Questionnaire standardized core and shoe comfort scores were 84.6 and 84.5, respectively. Average foot pain was 1.8 on a scale of 1-10. Patients were very/somewhat satisfied with status of foot in 76 % of feet and appearance of foot in 46 % of feet, based on Clubfoot Disease-Specific Instrument questions. Revision clubfoot surgery with calcaneocuboid fusion in patients 5-8 years of age showed an expected decline in functional outcome measures over a 17-year follow-up period. It still produced comparable

  15. Shock absorber servicing tool

    NASA Technical Reports Server (NTRS)

    Koepler, Jack L. (Inventor); Hill, Robert L. (Inventor)

    1981-01-01

    A tool to assist in the servicing of a shock absorber wherein the shock absorber is constructed of a pair of aligned gas and liquid filled chambers. Each of the chambers is separated by a movable separator member. Maximum efficiency of the shock absorber is achieved in the locating of a precise volume of gas within the gas chamber and a precise volume of liquid within the liquid chamber. The servicing tool of this invention employs a rod which is to connect with the separator and by observation of the position of the rod with respect to the gauge body, the location of the separator is ascertained even though it is not directly observable.

  16. Cervical Stand-Alone Polyetheretherketone Cage versus Zero-Profile Anchored Spacer in Single-Level Anterior Cervical Discectomy and Fusion : Minimum 2-Year Assessment of Radiographic and Clinical Outcome.

    PubMed

    Cho, Hyun-Jun; Hur, Junseok W; Lee, Jang-Bo; Han, Jin-Sol; Cho, Tai-Hyoung; Park, Jung-Yul

    2015-08-01

    We compared the clinical and radiographic outcomes of stand-alone polyetheretherketone (PEEK) cage and Zero-Profile anchored spacer (Zero-P) for single level anterior cervical discectomy and fusion (ACDF). We retrospectively reviewed 121 patients who underwent single level ACDF within 2 years (Jan 2011-Jan 2013) in a single institute. Total 50 patients were included for the analysis who were evaluated more than 2-year follow-up. Twenty-nine patients were allocated to the cage group (m : f=19 : 10) and 21 for Zero-P group (m : f=12 : 9). Clinical (neck disability index, visual analogue scale arm and neck) and radiographic (Cobb angle-segmental and global cervical, disc height, vertebral height) assessments were followed at pre-operative, immediate post-operative, post-3, 6, 12, and 24 month periods. Demographic features and the clinical outcome showed no difference between two groups. The change between final follow-up (24 months) and immediate post-op of Cobb-segmental angle (p=0.027), disc height (p=0.002), vertebral body height (p=0.033) showed statistically better outcome for the Zero-P group than the cage group, respectively. The Zero-Profile anchored spacer has some advantage after cage for maintaining segmental lordosis and lowering subsidence rate after single level anterior cervical discectomy and fusion.

  17. Absorbance enhancement in microplate wells for improved-sensitivity biosensors.

    PubMed

    Suárez, Guillaume; Santschi, Christian; Plateel, Gregory; Martin, Olivier J F; Riediker, Michael

    2014-06-15

    A generic optical biosensing strategy was developed that relies on the absorbance enhancement phenomenon occurring in a multiple scattering matrix. Experimentally, inserts made of glass fiber membrane were placed into microplate wells in order to significantly lengthen the trajectory of the incident light through the sample and therefore increase the corresponding absorbance. Enhancement factor was calculated by comparing the absorbance values measured for a given amount of dye with and without the absorbance-enhancing inserts in the wells. Moreover, the dilution of dye in solutions with different refractive indices (RI) clearly revealed that the enhancement factor increased with the ΔRI between the membrane and the surrounding medium, reaching a maximum value (EF>25) when the membranes were dried. On this basis, two H2O2-biosensing systems were developed based on the biofunctionalization of the glass fiber inserts either with cytochrome c or horseradish peroxidase (HRP) and the analytical performances were systematically compared with the corresponding bioassay in solution. The efficiency of the absorbance-enhancement approach was particularly clear in the case of the cytochrome c-based biosensor with a sensitivity gain of 40 folds and wider dynamic range. Therefore, the developed strategy represents a promising way to convert standard colorimetric bioassays into optical biosensors with improved sensitivity. Copyright © 2014 Elsevier B.V. All rights reserved.

  18. Chirp-Evoked Otoacoustic Emissions and Middle Ear Absorbance for Monitoring Ototoxicity in Cystic Fibrosis Patients.

    PubMed

    Garinis, Angela C; Keefe, Douglas H; Hunter, Lisa L; Fitzpatrick, Denis F; Putterman, Daniel B; McMillan, Garnett P; Gold, Jeffrey A; Feeney, M Patrick

    The goal of this study was to investigate the use of transient-evoked otoacoustic emissions (TEOAEs) and middle ear absorbance measurements to monitor auditory function in patients with cystic fibrosis (CF) receiving ototoxic medications. TEOAEs were elicited with a chirp stimulus using an extended bandwidth (0.71 to 8 kHz) to measure cochlear function at higher frequencies than traditional TEOAEs. Absorbance over a wide bandwidth (0.25 to 8 kHz) provides information on middle ear function. The combination of these time-efficient measurements has the potential to identify early signs of ototoxic hearing loss. A longitudinal study design was used to monitor the hearing of 91 patients with CF (median age = 25 years; age range = 15 to 63 years) who received known ototoxic medications (e.g., tobramycin) to prevent or treat bacterial lung infections. Results were compared to 37 normally hearing young adults (median age = 32.5 years; age range = 18 to 65 years) without a history of CF or similar treatments. Clinical testing included 226-Hz tympanometry, pure-tone air-conduction threshold testing from 0.25 to 16 kHz and bone conduction from 0.25 to 4 kHz. Experimental testing included wideband absorbance at ambient and tympanometric peak pressure and TEOAEs in three stimulus conditions: at ambient pressure and at tympanometric peak pressure using a chirp stimulus with constant incident pressure level across frequency and at ambient pressure using a chirp stimulus with constant absorbed sound power across frequency. At the initial visit, behavioral audiometric results indicated that 76 of the 157 ears (48%) from patients with CF had normal hearing, whereas 81 of these ears (52%) had sensorineural hearing loss for at least one frequency. Seven ears from four patients had a confirmed behavioral change in hearing threshold for ≥3 visits during study participation. Receiver operating characteristic curve analyses demonstrated that all three TEOAE conditions were

  19. Treatment Outcomes in the Ahmed Baerveldt Comparison Study after One Year of Follow-up

    PubMed Central

    Budenz, Donald L; Barton, Keith; Feuer, William J; Schiffman, Joyce; Costa, Vital P.; Godfrey, David G.; Buys, Yvonne

    2010-01-01

    Purpose To determine the relative efficacy and complications of the Ahmed FP7 Glaucoma Valve (AGV) and the Baerveldt 101–350 Glaucoma Implant (BGI) in refractory glaucoma. Design Multicenter randomized controlled clinical trial. Participants 276 patients, including 143 in the AGV group and 133 in the BGI group. Methods Patients aged 18–85 years with refractory glaucoma with intraocular pressure (IOP) greater than or equal to 18 mm Hg in whom an aqueous shunt was planned were randomized to undergo implantation of either an AGV or a BGI. Main Outcome Measures Primary outcome was failure, defined as IOP > 21 mm Hg or not reduced by 20%, IOP ≤ 5 mm Hg, reoperation for glaucoma or removal of implant, or loss of light perception vision. Secondary outcomes included mean IOP, visual acuity, use of supplemental medical therapy, and complications. Results Preoperative IOP (mean ± standard deviation, SD) was 31.2 ± 11.2 in the AGV group and 31.8 ± 12.5 in the BGI group (p = 0.71). At 1 year, IOP was 15.4 ± 5.5 mm Hg in the AGV group and 13.2 ± 6.8 mm Hg in the BGI group (p = 0.007). The number of glaucoma medications (mean ± SD) was 1.8 ± 1.3 in the AGV group and 1.5 ± 1.4 in the BGI group (p = 0.071). The cumulative probability of failure was 16.4% (standard error, SE = 3.1%) in the AGV group and 14.0% (SE = 3.1%) in the BGI group at 1 year (p = 0.52). More patients experienced early postoperative complications in the BGI group (n = 77, 58%) compared to the AGV group (n = 61, 43%, p = 0.016). Serious postoperative complications associated with reoperation and/or vision loss of ≥ 2 Snellen lines occurred in 29 patients (20%) in the AGV group and 45 patients (34%) in the BGI group (p = 0.014). Conclusions Although the average IOP after one year was slightly higher in patients who received an AGV, there were fewer early and serious postoperative complications associated with the use of the AGV than the BGI. PMID:20932583

  20. (C6H13N)2BiI5: A One-Dimensional Lead-Free Perovskite-Derivative Photoconductive Light Absorber.

    PubMed

    Zhang, Weichuan; Tao, Kewen; Ji, Chengmin; Sun, Zhihua; Han, Shiguo; Zhang, Jing; Wu, Zhenyue; Luo, Junhua

    2018-04-16

    Lead-free organic-inorganic hybrid perovskites have recently attracted intense interest as environmentally friendly, low-cost, chemically stable light absorbers. Here, we reported a new one-dimensional (1D) zigzag chainlike light-absorbing hybrid material of (C 6 H 13 N) 2 BiI 5 , in which the corner-sharing octahedral bismuth halide chains are surrounded by organic cations of tetramethylpiperidinium. This unique zigzag 1D hybrid perovskite-derivative material shows a narrow direct band gap of 2.02 eV and long-lived photoluminescence, which is encouraging for optoelectronic applications. Importantly, it behaves as a typical semiconducting material and displays obvious photoresponse in the visible-light range. This work opens a potential pathway for the further application of 1D lead-free hybrids.

  1. Schoolgirls' experience and appraisal of menstrual absorbents in rural Uganda: a cross-sectional evaluation of reusable sanitary pads.

    PubMed

    Hennegan, Julie; Dolan, Catherine; Wu, Maryalice; Scott, Linda; Montgomery, Paul

    2016-12-07

    Governments, multinational organisations, and charities have commenced the distribution of sanitary products to address current deficits in girls' menstrual management. The few effectiveness studies conducted have focused on health and education outcomes but have failed to provide quantitative assessment of girls' preferences, experiences of absorbents, and comfort. Objectives of the study were, first, to quantitatively describe girls' experiences with, and ratings of reliability and acceptability of different menstrual absorbents. Second, to compare ratings of freely-provided reusable pads (AFRIpads) to other existing methods of menstrual management. Finally, to assess differences in self-reported freedom of activity during menses according to menstrual absorbent. Cross-sectional, secondary analysis of data from the final survey of a controlled trial of reusable sanitary padand puberty education provision was undertaken. Participants were 205 menstruating schoolgirls from eight schools in rural Uganda. 72 girls who reported using the intervention-provided reusable pads were compared to those using existing improvised methods (predominately new or old cloth). Schoolgirls using reusable pads provided significantly higher ratings of perceived absorbent reliability across activities, less difficulties changing absorbents, and less disgust with cleaning absorbents. There were no significant differences in reports of outside garment soiling (OR 1.00 95%CI 0.51-1.99), or odour (0.84 95%CI 0.40-1.74) during the last menstrual period. When girls were asked if menstruation caused them to miss daily activities there were no differences between those using reusable pads and those using other existing methods. However, when asked about activities avoided during menstruation, those using reusable pads participated less in physical sports, working in the field, fetching water, and cooking. Reusable pads were rated favourably. This translated into some benefits for self

  2. Five-year outcomes of percutaneous versus surgical coronary revascularization in patients with diabetes mellitus (from the CREDO-Kyoto PCI/CABG Registry Cohort-2).

    PubMed

    Marui, Akira; Kimura, Takeshi; Nishiwaki, Noboru; Mitsudo, Kazuaki; Komiya, Tatsuhiko; Hanyu, Michiya; Shiomi, Hiroki; Tanaka, Shiro; Sakata, Ryuzo

    2015-04-15

    We investigated the impact of diabetes mellitus on long-term outcomes of percutaneous coronary intervention (PCI) in the drug-eluting stent era versus coronary artery bypass grafting (CABG) in a real-world population with advanced coronary disease. We identified 3,982 patients with 3-vessel and/or left main disease of 15,939 patients with first coronary revascularization enrolled in the Coronary Revascularization Demonstrating Outcome Study in Kyoto PCI/CABG Registry Cohort-2 (patients without diabetes: n = 1,984 [PCI: n = 1,123 and CABG: n = 861], and patients with diabetes: n = 1,998 [PCI: n = 1,065 and CABG: n = 933]). Cumulative 5-year incidence of all-cause death after PCI was significantly higher than after CABG both in patients without and with diabetes (19.8% vs 16.2%, p = 0.01, and 22.9% vs 19.0%, p = 0.046, respectively). After adjusting confounders, the excess mortality risk of PCI relative to CABG was no longer significant (hazard ratio [HR] 1.16; 95% confidence interval [CI] 0.88 to 1.54; p = 0.29) in patients without diabetes, whereas it remained significant (HR 1.31; 95% CI 1.01 to 1.70; p = 0.04) in patients with diabetes. The excess adjusted risks of PCI relative to CABG for cardiac death, myocardial infarction (MI), and any coronary revascularization were significant in both patients without (HR 1.59, 95% CI 1.01 to 2.51, p = 0.047; HR 2.16, 95% CI 1.20 to 3.87, p = 0.01; and HR 3.30, 95% CI 2.55 to 4.25, p <0.001, respectively) and with diabetes (HR 1.45, 95% CI 1.00 to 2.51, p = 0.047; HR 2.31, 95% CI 1.31 to 4.08, p = 0.004; and HR 3.70, 95% CI 2.91 to 4.69, p <0.001, respectively). There was no interaction between diabetic status and the effect of PCI relative to CABG for all-cause death, cardiac death, MI, and any revascularization. In conclusion, in both patients without and with diabetes with 3-vessel and/or left main disease, CABG compared with PCI was associated with better 5-year outcomes in terms of cardiac death, MI, and any coronary

  3. The effect of poorly absorbed solute on intestinal absorption.

    PubMed

    Menzies, I S; Jenkins, A P; Heduan, E; Catt, S D; Segal, M B; Creamer, B

    1990-12-01

    To determine the effects of poorly absorbed solute on intestinal absorption, the urinary recovery of ingested lactulose, L-rhamnose, D-xylose, and 3-O-methyl-D-glucose was measured after simultaneous ingestion of various 'loads' of mannitol given in iso-osmolar solution. Mannitol reduced intestinal uptake of the poorly absorbed test sugars, lactulose and L-rhamnose; uptake of D-xylose and 3-O-methyl-D-glucose, which are absorbed by carrier-mediated transport largely from the jejunum, was less affected. The dose-response effect of mannitol on the absorption of L-rhamnose was approximately exponential; doses of 5, 10, and 20 g mannitol reduced the average urinary excretion of L-rhamnose by 34.7%, 51.7%, and 61.2%, respectively. In this respect, an osmotically equivalent load of lactulose, ingested as 'solute', was approximately twice as effective as mannitol in reducing L-rhamnose absorption, probably because lactulose is more poorly absorbed than mannitol (less than 1.0% versus 32-41%). Ingestion of other poorly absorbed solutes such as raffinose, sorbitol, xylitol, magnesium sulphate, and sodium sulphate also significantly depressed the absorption of L-rhamnose; in contrast, more efficiently absorbed solutes, such as sodium chloride, glucose, glycerol, and urea had little effect.

  4. Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes.

    PubMed

    Zinman, Bernard; Wanner, Christoph; Lachin, John M; Fitchett, David; Bluhmki, Erich; Hantel, Stefan; Mattheus, Michaela; Devins, Theresa; Johansen, Odd Erik; Woerle, Hans J; Broedl, Uli C; Inzucchi, Silvio E

    2015-11-26

    The effects of empagliflozin, an inhibitor of sodium-glucose cotransporter 2, in addition to standard care, on cardiovascular morbidity and mortality in patients with type 2 diabetes at high cardiovascular risk are not known. We randomly assigned patients to receive 10 mg or 25 mg of empagliflozin or placebo once daily. The primary composite outcome was death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke, as analyzed in the pooled empagliflozin group versus the placebo group. The key secondary composite outcome was the primary outcome plus hospitalization for unstable angina. A total of 7020 patients were treated (median observation time, 3.1 years). The primary outcome occurred in 490 of 4687 patients (10.5%) in the pooled empagliflozin group and in 282 of 2333 patients (12.1%) in the placebo group (hazard ratio in the empagliflozin group, 0.86; 95.02% confidence interval, 0.74 to 0.99; P=0.04 for superiority). There were no significant between-group differences in the rates of myocardial infarction or stroke, but in the empagliflozin group there were significantly lower rates of death from cardiovascular causes (3.7%, vs. 5.9% in the placebo group; 38% relative risk reduction), hospitalization for heart failure (2.7% and 4.1%, respectively; 35% relative risk reduction), and death from any cause (5.7% and 8.3%, respectively; 32% relative risk reduction). There was no significant between-group difference in the key secondary outcome (P=0.08 for superiority). Among patients receiving empagliflozin, there was an increased rate of genital infection but no increase in other adverse events. Patients with type 2 diabetes at high risk for cardiovascular events who received empagliflozin, as compared with placebo, had a lower rate of the primary composite cardiovascular outcome and of death from any cause when the study drug was added to standard care. (Funded by Boehringer Ingelheim and Eli Lilly; EMPA-REG OUTCOME ClinicalTrials.gov number

  5. Ten-year outcome of enzyme replacement therapy with agalsidase beta in patients with Fabry disease.

    PubMed

    Germain, Dominique P; Charrow, Joel; Desnick, Robert J; Guffon, Nathalie; Kempf, Judy; Lachmann, Robin H; Lemay, Roberta; Linthorst, Gabor E; Packman, Seymour; Scott, C Ronald; Waldek, Stephen; Warnock, David G; Weinreb, Neal J; Wilcox, William R

    2015-05-01

    Fabry disease results from deficient α-galactosidase A activity and globotriaosylceramide accumulation causing renal insufficiency, strokes, hypertrophic cardiomyopathy and early demise. We assessed the 10-year outcome of recombinant α-galactosidase A therapy. The outcomes (severe clinical events, renal function, cardiac structure) of 52/58 patients with classic Fabry disease from the phase 3 clinical trial and extension study, and the Fabry Registry were evaluated. Disease progression rates for patients with low renal involvement (LRI, n=32) or high renal involvement (HRI, n=20) at baseline were assessed. 81% of patients (42/52) did not experience any severe clinical event during the treatment interval and 94% (49/52) were alive at the end of the study period. Ten patients reported a total of 16 events. Patients classified as LRI started therapy 13 years younger than HRI (mean 25 years vs 38 years). Mean slopes for estimated glomerular filtration rate for LRI and HRI were -1.89 mL/min/1.73 m(2)/year and -6.82 mL/min/1.73 m(2)/year, respectively. Overall, the mean left ventricular posterior wall thickness and interventricular septum thickness remained unchanged and normal. Patients who initiated treatment at age ≥ 40 years exhibited significant increase in left ventricular posterior wall thickness and interventricular septum thickness. Mean plasma globotriaosylceramide normalised within 6 months. This 10-year study documents the effectiveness of agalsidase beta (1 mg/kg/2 weeks) in patients with Fabry disease. Most patients remained alive and event-free. Patients who initiated treatment at a younger age and with less kidney involvement benefited the most from therapy. Patients who initiated treatment at older ages and/or had advanced renal disease experienced disease progression. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  6. Ten-year outcome of enzyme replacement therapy with agalsidase beta in patients with Fabry disease

    PubMed Central

    Germain, Dominique P; Charrow, Joel; Desnick, Robert J; Guffon, Nathalie; Kempf, Judy; Lachmann, Robin H; Lemay, Roberta; Linthorst, Gabor E; Packman, Seymour; Scott, C Ronald; Waldek, Stephen; Warnock, David G; Weinreb, Neal J; Wilcox, William R

    2015-01-01

    Background Fabry disease results from deficient α-galactosidase A activity and globotriaosylceramide accumulation causing renal insufficiency, strokes, hypertrophic cardiomyopathy and early demise. We assessed the 10-year outcome of recombinant α-galactosidase A therapy. Methods The outcomes (severe clinical events, renal function, cardiac structure) of 52/58 patients with classic Fabry disease from the phase 3 clinical trial and extension study, and the Fabry Registry were evaluated. Disease progression rates for patients with low renal involvement (LRI, n=32) or high renal involvement (HRI, n=20) at baseline were assessed. Results 81% of patients (42/52) did not experience any severe clinical event during the treatment interval and 94% (49/52) were alive at the end of the study period. Ten patients reported a total of 16 events. Patients classified as LRI started therapy 13 years younger than HRI (mean 25 years vs 38 years). Mean slopes for estimated glomerular filtration rate for LRI and HRI were −1.89 mL/min/1.73 m2/year and −6.82 mL/min/1.73 m2/year, respectively. Overall, the mean left ventricular posterior wall thickness and interventricular septum thickness remained unchanged and normal. Patients who initiated treatment at age ≥40 years exhibited significant increase in left ventricular posterior wall thickness and interventricular septum thickness. Mean plasma globotriaosylceramide normalised within 6 months. Conclusions This 10-year study documents the effectiveness of agalsidase beta (1 mg/kg/2 weeks) in patients with Fabry disease. Most patients remained alive and event-free. Patients who initiated treatment at a younger age and with less kidney involvement benefited the most from therapy. Patients who initiated treatment at older ages and/or had advanced renal disease experienced disease progression. PMID:25795794

  7. An efficient absorbing system for spectrophotometric determination of nitrogen dioxide

    NASA Astrophysics Data System (ADS)

    Kaveeshwar, Rachana; Amlathe, Sulbha; Gupta, V. K.

    A simple and sensitive spectrophotometric method for determination of atmospheric nitrogen dioxide using o-nitroaniline as an efficient absorbing, as well as diazotizing, reagent is described. o-Nitroaniline present in the absorbing medium is diazotized by the absorbed nitrite ion to form diazonium compound. This is later coupled with 1-amino-2-naphthalene sulphonic acid (ANSA) in acidic medium to give red-violet-coloured dye,having λmax = 545 nm. The isoamyl extract of the red azo dye has λmax = 530 nm. The proposed reagents has ≈ 100% collection efficiency and the stoichiometric ratio of NO 2:NO 2- is 0.74. The other important analytical parameters have been investigated. By employing solvent extraction the sensitivity of the reaction was increased and up to 0.03 mg m -3 nitrogen dioxide could be estimated.

  8. The association of maternal vitamin D status with infant birth outcomes, postnatal growth and adiposity in the first 2 years of life in a multi-ethnic Asian population: the Growing Up in Singapore Towards healthy Outcomes (GUSTO) cohort study.

    PubMed

    Ong, Yi Lin; Quah, Phaik Ling; Tint, Mya Thway; Aris, Izzuddin M; Chen, Ling Wei; van Dam, Rob M; Heppe, Denise; Saw, Seang-Mei; Godfrey, Keith M; Gluckman, Peter D; Chong, Yap Seng; Yap, Fabian; Lee, Yung Seng; Foong-Fong Chong, Mary

    2016-08-01

    Maternal vitamin D status during pregnancy has been associated with infant birth and postnatal growth outcomes, but reported findings have been inconsistent, especially in relation to postnatal growth and adiposity outcomes. In a mother-offspring cohort in Singapore, maternal plasma vitamin D was measured between 26 and 28 weeks of gestation, and anthropometric measurements were obtained from singleton offspring during the first 2 years of life with 3-month follow-up intervals to examine birth, growth and adiposity outcomes. Associations were analysed using multivariable linear regression. Of a total of 910 mothers, 13·2 % were vitamin D deficient (<50 nmol/l) and 26·5 % were insufficient (50-75 nmol/l). After adjustment for potential confounders and multiple testing, no statistically significant associations were observed between maternal vitamin D status and any of the birth outcomes - small for gestational age (OR 1·00; 95 % CI 0·56, 1·79) and pre-term birth (OR 1·16; 95 % CI 0·64, 2·11) - growth outcomes - weight-for-age z-scores, length-for-age z-scores, circumferences of the head, abdomen and mid-arm at birth or postnatally - and adiposity outcomes - BMI, and skinfold thickness (triceps, biceps and subscapular) at birth or postnatally. Maternal vitamin D status in pregnancy did not influence infant birth outcomes, postnatal growth and adiposity outcomes in this cohort, perhaps due to the low prevalence (1·6 % of the cohort) of severe maternal vitamin D deficiency (defined as of <30·0 nmol/l) in our population.

  9. Treatment outcomes after 3 years in neovascular age-related macular degeneration using a treat-and-extend regimen.

    PubMed

    Rayess, Nadim; Houston, S K Steven; Gupta, Omesh P; Ho, Allen C; Regillo, Carl D

    2015-01-01

    To determine 3-year treatment outcomes after 1 to 3 years of ranibizumab or bevacizumab therapy using a treat-and-extend regimen in patients with neovascular age-related macular degeneration (AMD). Retrospective, interventional, consecutive case series. We treated 212 eyes from 196 patients diagnosed with treatment-naive neovascular AMD between January 2009 and March 2013; they were treated with either ranibizumab or bevacizumab for a minimum of 1 year, using a treat-and-extend regimen. The main outcome measures were change from baseline best-corrected Snellen visual acuity (BCVA), proportion of eyes losing <3 BCVA lines, proportion of eyes gaining ≥ 3 BCVA lines, change from baseline central retinal thickness, and mean number of injections at 1, 2 and 3 years of follow-up. The mean follow-up period was 1.88 years (median, 2 years). At baseline, mean BCVA was 20/139; it improved to 20/79 (P < 0.001) after 1 year of treatment and was maintained at 20/69 and 20/64 at 2 and 3 years follow-up (P < 0.001), respectively. At baseline, mean central retinal thickness was 351 μm and significantly decreased to 285 μm, 275 μm and 276 μm at 1, 2 and 3 years of follow-up (P < 0.001), respectively. Patients received, on average, 7.6, 5.7 and 5.8 injections over years 1, 2 and 3 of treatment, respectively. At final follow-up, 94% of eyes had lost <3 lines BCVA, and 34.4% of eyes had gained ≥ 3 lines BCVA. The treat-and-extend regimen is effective in achieving and maintaining visual and anatomic improvements in patients with neovascular AMD for up to 3 years of treatment. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Reduction in 2-year recurrent risk score and improved behavioral outcomes after participation in the "Beating Heart Problems" self-management program: results of a randomized controlled trial.

    PubMed

    Murphy, Barbara M; Worcester, Marian U C; Higgins, Rosemary O; Elliott, Peter C; Le Grande, Michael R; Mitchell, Fiona; Navaratnam, Hema; Turner, Alyna; Grigg, Leeanne; Tatoulis, James; Goble, Alan J

    2013-01-01

    While behavior change can improve risk factor profiles and prognosis after an acute cardiac event, patients need assistance to achieve sustained lifestyle changes. We developed the "Beating Heart Problems" cognitive-behavioral therapy and motivational interviewing program to support patients to develop behavioral and cognitive self-management skills. We report the results of a randomized controlled trial of the program. Patients (n = 275) consecutively admitted to 2 Melbourne hospitals after acute myocardial infarction (32%), coronary artery bypass graft surgery (40%), or percutaneous coronary intervention (28%) were randomized to treatment (T; n = 139) or control (C; n = 136). T group patients were invited to participate in the 8-week group-based program. Patients underwent risk factor screening 6 weeks after hospital discharge (before randomization) and again 4 and 12 months later. At both the followups, T and C groups were compared on 2-year risk of a recurrent cardiac event and key behavioral outcomes, using both intention-to-treat and "completers only" analyses. Patients ranged in age from 32 to 75 years (mean = 59.0 years; SD - 9.1 years). Most patients (86%) were men. Compared with the C group patients, T group patients tended toward greater reduction in 2-year risk, at both the 4- and 12-month followups. Significant benefits in dietary fat intake and functional capacity were also evident. The "Beating Heart Problems" program showed modest but important benefit over usual care at 4 and, to a lesser extent, 12 months. Modifications to the program such as the inclusion of booster sessions and translation to online delivery are likely to improve outcomes.

  11. A Cataract Surgery Training Program: 2-Year Outcome After Launching.

    PubMed

    Yu, A-Yong; Wang, Qin-Mei; Li, Jin; Huang, Fang; Golnik, Karl

    2016-01-01

    To investigate whether a short-term training program can produce competent cataract surgeons. This observational pilot study enrolled 12 trainees who could not perform phacoemulsification independently. The training consisted of 2 phases. During the first 3-month phase, trainees were taught phacoemulsification through wet laboratory exposure and deliberate practice in patients at the training center in the Eye Hospital of Wenzhou Medical University in China. The second phase consisted of performing 50 cases at the trainees׳ home institution with supports from instructors of the first phase. Trainees׳ surgical results were followed-up. The surgical skill as measured by the Ophthalmology Surgical Competency Assessment Rubric (OSCAR) and surgical outcomes were analyzed. During the first phase trainees performed 193.3 ± 95.4 wet laboratory cases and 557 eyes in patients. The complication rate was 0.54%. The OSCAR scores improved significantly (p < 0.01) in the first phase. At the second phase, all the trainees could carry out phacoemulsification at their home hospital and the complication rate was 1.87%. During the long-term follow-up, 4936 cases of phacoemulsification were performed and the complication rate was 0.87%. Trainees succeeded in performing phacoemulsification safely and skillfully through a limited short period of training by wet laboratory exposure, deliberate practice in patients, and frequent formative feedback provided by the OSCAR tool. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  12. Peritraumatic panic attacks and health outcomes two years after psychological trauma: implications for intervention and research.

    PubMed

    Boscarino, Joseph A; Adams, Richard E

    2009-05-15

    Several studies have suggested that experiencing a peritraumatic panic attack (PPA) during a traumatic event predicts future mental health status. Some investigators have suggested that this finding has psychotherapeutic significance. We assessed the hypothesis that PPA was not related to longer-term health status after event exposure, once background confounders were controlled. In our study we assessed exposure to the World Trade Center disaster (WTCD) and other negative life events, demographic factors, social support, self-esteem, and panic attack onset in predicting health outcome among 1681 New York City residents 2 years after the attack. Initial bivariate results indicated that a PPA was related to a number of adverse outcomes 2 years after the WTCD, including posttraumatic stress disorder, depression, poor physical health, anxiety, binge drinking, and mental health treatment seeking. However, when multivariate (MV) models were estimated adjusting for potential confounders, most of these associations were either non-significant or substantially reduced. Contrary to previous predictions, these MV models revealed that recent negative life events and current self-esteem at follow-up were the best predictors of health outcomes, not PPA. Although post-trauma interventions may target individuals who experienced PPA after traumatic exposures, reducing the long-term health consequences following such exposures based on PPA alone may be problematic. Modifications of psychopathology constructs based on the reported correlation between PPA and post-trauma outcomes may be premature.

  13. Remembrance and time passed: Memory outcomes 4-11 years after pediatric epilepsy surgery.

    PubMed

    Puka, Klajdi; Smith, Mary Lou

    2016-11-01

    Little is known about the long-term cognitive outcomes following pediatric epilepsy surgery. Although the evidence for change within the first 2 years is not compelling, the plasticity of the immature brain may allow for improvements in the long term. This study examined memory function in a cohort of surgical and nonsurgical patients at baseline and 4-11 years after. Participants were 88 patients (mean age 20.05, standard deviation [SD] 4.21 years) with childhood-onset intractable epilepsy; 53 had undergone resective epilepsy surgery. Verbal and visual memory were assessed at baseline and follow-up using standardized tests of recall of stories, faces, word pairs, and word lists. Improvements over time were not found; outcomes were largely independent of surgical status. Those who were seizure-free at follow-up had better story recall at both times (p = 0.028), and did not show improvement. Among patients with extratemporal lobe epilepsy, significant declines in word list recall were found over time irrespective of surgical or seizure status (p = 0.010). Effects of laterality of seizure focus were evident only when examining patients with temporal lobe epilepsy (TLE); patients with left TLE had lower story recall scores compared to patients with right TLE at long-term follow-up (p = 0.043). Patients who became seizure-free had some advantages in memory, but did not show improvements over time. These findings have important implications for understanding potential outcomes from surgery or continued use of antiepileptic medications. Wiley Periodicals, Inc. © 2016 International League Against Epilepsy.

  14. Contextual factors influence work outcomes in employed patients with ankylosing spondylitis starting etanercept: 2-year results from AS@Work.

    PubMed

    Boonen, Annelies; Boone, Caroline; Albert, Adelin; Mielants, Herman

    2018-05-01

    The aim was to determine changes over time in work outcomes and investigate the predictive value of baseline personal and work-related factors on the evolution of work outcomes among employed patients with AS initiating etanercept. Employment status, absenteeism and presenteeism were assessed using the Work Productivity and Activity Impairment for AS questionnaire in a 24-month open-label, observational study (NCT01421303). The potential effect of baseline factors on work outcomes was analysed using predictive modelling (Cox regression and linear mixed models). After 24 months, 11/75 (14.7%) patients had permanently withdrawn from employment (seven because of AS). Absenteeism and presenteeism decreased significantly within 6 months of etanercept treatment and remained stable thereafter. Predictive modelling indicated that male sex (hazard ratio = 0.18; 95% CI: 0.04, 0.85), (log) number of working hours per week (hazard ratio = 0.13; 95% CI: 0.03, 0.51) and the possibility of developing skills (hazard ratio = 0.42; 95% CI: 0.19, 0.91) positively influenced time in employment. Over time, lower absenteeism was significantly associated with the quality of contact with colleagues [coefficient (s.e.): -0.35 (0.10)] and importance of the job for quality of life [-0.49 (0.17)], and higher absenteeism with current smoking [1.66 (0.44)] and change in job because of illness [1.51 (0.66)]. Over time, lower presenteeism was associated with male sex [-14.5 (2.64)], the possibility of postponing work [-6.60 (2.73)], quality of contact with colleagues [-2.04 (0.96)] and >50 workers in the company [-7.65 (2.76)], and higher presenteeism with manual profession [8.41 (2.72)]. Contextual factors influence work outcomes over time and should not be ignored when aiming to improve work outcomes in patients with AS. ClinicalTrials.gov, http://clinicaltrials.gov, NCT01421303.

  15. The Ahmed versus Baerveldt study: three-year treatment outcomes.

    PubMed

    Christakis, Panos G; Tsai, James C; Kalenak, Jeffrey W; Zurakowski, David; Cantor, Louis B; Kammer, Jeffrey A; Ahmed, Iqbal I K

    2013-11-01

    To compare 2 commonly used aqueous drainage devices for the treatment of refractory glaucoma. International, multicenter, randomized trial. Patients aged 18 years or older with uncontrolled or high-risk glaucoma refractory to maximum medical therapy, many of whom had failed trabeculoplasty and trabeculectomy. Eligible patients were randomized to an Ahmed-FP7 valve implant (New World Medical, Inc., Rancho Cucamonga, CA) or a Baerveldt-350 implant (Abbott Medical Optics, Inc., Santa Ana, CA) using a standardized surgical technique. The primary outcome was failure, defined as intraocular pressure (IOP) outside of the target range (5-18 mmHg, with ≥20% reduction from baseline) for 2 consecutive visits after 3 months, vision-threatening complications, de novo glaucoma procedures, or loss of light perception. Secondary outcome measures include IOP, medication use, visual acuity, complications, and interventions. A total of 238 patients were enrolled and randomized; 124 received the Ahmed implant and 114 received the Baerveldt implant. Baseline characteristics were similar in both groups. Half the study group had secondary glaucoma, and 37% had previously failed trabeculectomy. The mean preoperative IOP was 31.4±10.8 mmHg on 3.1±1.0 glaucoma medications. Median baseline Snellen visual acuity was 20/100. At 3 years, the cumulative probability of failure was 51% in the Ahmed group and 34% in the Baerveldt group (P = 0.03). Mean IOP was 15.7±4.8 mmHg in the Ahmed group (49% reduction) and 14.4±5.1 mmHg in the Baerveldt group (55% reduction; P = 0.09). Mean number of glaucoma medications was 1.8±1.4 in the Ahmed group (42% reduction) and 1.1±1.3 in the Baerveldt group (65% reduction; P = 0.002). There was a moderate but similar decrease in visual acuity in both groups (P< 0.001). The 2 groups had similar complication rates (52% Ahmed, 62% Baerveldt; P = 0.12); however, the Baerveldt group had a higher rate of hypotony-related vision-threatening complications (0

  16. Satisfactory surgical outcome of T2 gastric cancer after modified D2 lymphadenectomy.

    PubMed

    Zhang, Shupeng; Wu, Liangliang; Wang, Xiaona; Ding, Xuewei; Liang, Han

    2017-04-01

    Though D2 lymphadenectomy has been increasingly regarded as standard surgical procedure for advanced gastric cancer (GC), the modified D2 (D1 + 7, 8a and 9) lymphadenectomy may be more suitable than D2 dissection for T2 stage GC. The purpose of this study is to elucidate whether the surgical outcome of modified D2 lymphadenectomy was comparable to that of standard D2 dissection in T2 stage GC patients. A retrospective cohort study with 77 cases and 77 controls matched for baseline characteristics was conducted. Patients were categorized into two groups according to the extent of lymphadenectomy: the modified D2 group (mD2) and the standard D2 group (D2). Surgical outcome and recurrence date were compared between the two groups. The 5-year overall survival (OS) rate was 71.4% for patients accepted mD2 lymphadenectomy and 70.1% for those accepted standard D2, respectively, and the difference was not statistically significant. Multivariate survival analysis revealed that curability, tumor size, TNM stage and postoperative complications were independently prognostic factors for T2 stage GC patients. Patients in the mD2 group tended to have less intraoperative blood loss (P=0.001) and shorter operation time (P<0.001) than those in the D2 group. While there were no significant differences in recurrence rate and types, especially lymph node recurrence, between the two groups. The surgical outcome of mD2 lymphadenectomy was equal to that of standard D2, and the use of mD2 instead of standard D2 can be a better option for T2 stage GC.

  17. Serial 5-Year Evaluation of Side Branches Jailed by Bioresorbable Vascular Scaffolds Using 3-Dimensional Optical Coherence Tomography: Insights From the ABSORB Cohort B Trial (A Clinical Evaluation of the Bioabsorbable Everolimus Eluting Coronary Stent System in the Treatment of Patients With De Novo Native Coronary Artery Lesions).

    PubMed

    Onuma, Yoshinobu; Grundeken, Maik J; Nakatani, Shimpei; Asano, Taku; Sotomi, Yohei; Foin, Nicolas; Ng, Jaryl; Okamura, Takayuki; Wykrzykowska, Joanna J; de Winter, Robbert J; van Geuns, Robert-Jan; Koolen, Jacques; Christiansen, Evald; Whitbourn, Robert; McClean, Dougal; Smits, Pieter; Windecker, Stephan; Ormiston, John A; Serruys, Patrick W

    2017-09-01

    The long-term fate of Absorb bioresorbable vascular scaffold (Abbott Vascular, Santa Clara, CA) struts jailing side branch ostia has not been clarified. We therefore evaluate serially (post-procedure and at 6 months, 1, 2, 3, and 5 years) the appearance and fate of jailed Absorb bioresorbable vascular scaffold struts. We performed 3-dimensional optical coherence tomographic analysis of the ABSORB Cohort B trial (A Clinical Evaluation of the Bioabsorbable Everolimus Eluting Coronary Stent System in the Treatment of Patients With De Novo Native Coronary Artery Lesions) up to 5 years using a novel, validated cut-plane analysis method. We included 29 patients with a total of 85 side branch ostia. From the 12 ostia which could be assessed in true serial fashion, 7 showed a pattern of initial decrease in the ostial area free from struts, followed by an increase in strut-free ostial area toward the end of the 5 years of follow-up. In a repeated-measures analysis with time as fixed variable and ostial area free from struts as dependent variable, we showed a numeric decrease in the estimated ostial area free from struts from 0.75 mm 2 (baseline) to 0.68 mm 2 (first follow-up visit at 6 months or 1 year) and 0.63 mm 2 (second follow-up visit at 2 or 3 years). However, from the second visit to the 5-year follow-up visit, there was a statistically significant increase from 0.63 to 0.89 mm 2 ( P =0.001). Struts overlying an ostium divided the ostium into compartments, and the number of these compartments decreased over time. This study showed that in most cases, the side branch ostial area free from struts initially decreased. However, with full scaffold bioresorption, the ostial area free from scaffold increased between 2 to 3 years and 5 years in the vast majority of patients. URL: http://www.clinicaltrials.gov. Unique identifier: NCT00856856. © 2017 American Heart Association, Inc.

  18. Electromagnetic Wave Absorbing Properties of Amorphous Carbon Nanotubes

    PubMed Central

    Zhao, Tingkai; Hou, Cuilin; Zhang, Hongyan; Zhu, Ruoxing; She, Shengfei; Wang, Jungao; Li, Tiehu; Liu, Zhifu; Wei, Bingqing

    2014-01-01

    Amorphous carbon nanotubes (ACNTs) with diameters in the range of 7–50 nm were used as absorber materials for electromagnetic waves. The electromagnetic wave absorbing composite films were prepared by a dip-coating method using a uniform mixture of rare earth lanthanum nitrate doped ACNTs and polyvinyl chloride (PVC). The microstructures of ACNTs and ACNT/PVC composites were characterized using transmission electron microscope and X-ray diffraction, and their electromagnetic wave absorbing properties were measured using a vector-network analyzer. The experimental results indicated that the electromagnetic wave absorbing properties of ACNTs are superior to multi-walled CNTs, and greatly improved by doping 6 wt% lanthanum nitrate. The reflection loss (R) value of a lanthanum nitrate doped ACNT/PVC composite was −25.02 dB at 14.44 GHz, and the frequency bandwidth corresponding to the reflector loss at −10 dB was up to 5.8 GHz within the frequency range of 2–18 GHz. PMID:25007783

  19. Investigations on Absorber Materials at Cryogenic Temperatures

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Marhauser, Frank; Elliott, Thomas; Rimmer, Robert

    2009-05-01

    In the framework of the 12 GeV upgrade project for the Continuous Electron Beam Accelerator Facility (CEBAF) improvements are being made to refurbish cryomodules housing Thomas Jefferson National Accelerator Facility's (JLab) original 5-cell cavities. Recently we have started to look into a possible simplification of the existing Higher Order Mode (HOM) absorber design combined with the aim to find alternative material candidates. The absorbers are implemented in two HOM-waveguides immersed in the helium bath and operate at 2 K temperature. We have built a cryogenic setup to perform measurements on sample load materials to investigate their lossy characteristics and variationsmore » from room temperature down to 2 K. Initial results are presented in this paper.« less

  20. Absorbent product and articles made therefrom

    NASA Technical Reports Server (NTRS)

    Dawn, F. S.; Correale, J. V. (Inventor)

    1982-01-01

    A multilayer absorbent product for use in contact with the skin to absorb fluids is described. The product has a water pervious facing layer for contacting the skin, and a first fibrous wicking layer overlaying the water pervious layer. A first container section is defined by inner and outer layers of a water pervious wicking material in between a first absorbent mass and a second container section defined by inner and outer layers of a water pervious wicking material between what is disposed a second absorbent mass, and a liquid impermeable/gas permeable layer overlaying the second fibrous wicking layer.

  1. Development of the electrochemically regenerable carbon dioxide absorber for portable life support system application

    NASA Technical Reports Server (NTRS)

    Woods, R. R.; Heppner, D. B.; Marshall, R. D.; Quattrone, P. D.

    1979-01-01

    As the length of manned space missions increase, more ambitious extravehicular activities (EVAs) are required. For the projected longer mission the use of expendables in the portable life support system (PLSS) will become prohibited due to high launch weight and volume requirements. Therefore, the development of a regenerable CO2 absorber for the PLSS application is highly desirable. The paper discusses the concept, regeneration mechanism, performance, system design, and absorption/regeneration cycle testing of a most promising concept known as ERCA (Electrochemically Regenerable CO2 Absorber). This concept is based on absorbing CO2 into an alkaline absorbent similar to LiOH. The absorbent is an aqueous solution supported in a porous matrix which can be electrochemically regenerated on board the primary space vehicle. With the metabolic CO2 recovery the ERCA concept results in a totally regenerable CO2 scrubber. The ERCA test hardware has passed 200 absorption/regeneration cycles without performance degradation.

  2. Thin film absorber for a solar collector

    DOEpatents

    Wilhelm, William G.

    1985-01-01

    This invention pertains to energy absorbers for solar collectors, and more particularly to high performance thin film absorbers. The solar collectors comprising the absorber of this invention overcome several problems seen in current systems, such as excessive hardware, high cost and unreliability. In the preferred form, the apparatus features a substantially rigid planar frame with a thin film window bonded to one planar side of the frame. An absorber in accordance with the present invention is comprised of two thin film layers that are sealed perimetrically. In a preferred embodiment, thin film layers are formed from a metal/plastic laminate. The layers define a fluid-tight planar envelope of large surface area to volume through which a heat transfer fluid flows. The absorber is bonded to the other planar side of the frame. The thin film construction of the absorber assures substantially full envelope wetting and thus good efficiency. The window and absorber films stress the frame adding to the overall strength of the collector.

  3. Stretchable Metamaterial Absorber Using Liquid Metal-Filled Polydimethylsiloxane (PDMS)

    PubMed Central

    Kim, Kyeongseob; Lee, Dongju; Eom, Seunghyun; Lim, Sungjoon

    2016-01-01

    A stretchable metamaterial absorber is proposed in this study. The stretchability was achieved by liquid metal and polydimethylsiloxane (PDMS). To inject liquid metal, microfluidic channels were fabricated using PDMS powers and microfluidic-channel frames, which were built using a three-dimensional printer. A top conductive pattern and ground plane were designed after considering the easy injection of liquid metal. The proposed metamaterial absorber comprises three layers of PDMS substrate. The top layer is for the top conductive pattern, and the bottom layer is for the meandered ground plane. Flat PDMS layers were inserted between the top and bottom PDMS layers. The measured absorptivity of the fabricated absorber was 97.8% at 18.5 GHz, and the absorption frequency increased from 18.5 to 18.65 GHz as the absorber was stretched from its original length (5.2 cm) to 6.4 cm. PMID:27077861

  4. Solar sustained plasma/absorber conceptual design

    NASA Technical Reports Server (NTRS)

    Rodgers, R. J.; Krascella, N. L.; Kendall, J. S.

    1979-01-01

    A space power system concept was evaluated which uses concentrated solar energy to heat a working fluid to temperatures as high as 4000 K. The high temperature working fluid could be used for efficient electric power production in advanced thermal or magnetohydrodynamic conversion cycles. Energy absorber configurations utilizing particles or cesium vapor absorber material were investigaed. Results of detailed radiant heat transfer calculations indicated approximately 86 percent of the incident solar energy could be absorbed within a 12-cm-dia flowing stream of gas borne carbon particles. Calculated total energy absorption in the cesium vapor seeded absorber configuration ranged from 34 percent to 64 percent of the incident solar energy. Solar flux concentration ratios of between approximately 3000 and 10,000 will be required to sustain absorber temperatures in the range from 3000 K to 4000 K.

  5. Structured Metal Film as Perfect Absorber

    NASA Astrophysics Data System (ADS)

    Xiong, Xiang; Jiang, Shang-Chi; Peng, Ru-Wen; Wang, Mu

    2014-03-01

    With standing U-shaped resonators, fish-spear-like resonator has been designed for the first time as the building block to assemble perfect absorbers. The samples have been fabricated with two-photon polymerization process and FTIR measurement results support the effectiveness of the perfect absorber design. In such a structure the polarization-dependent resonance occurs between the tines of the spears instead of the conventional design where the resonance occurs between the metallic layers separated by a dielectric interlayer. The incident light neither transmits nor reflects back which results in unit absorbance. The power of light is trapped between the tines of spears and finally be absorbed. The whole structure is covered with a continuous metallic layer with good thermo-conductance, which provides an excellent approach to deal with heat dissipation, is enlightening in exploring metamaterial absorbers.

  6. Enhancement mechanism of the additional absorbent on the absorption of the absorbing composite using a type-based mixing rule

    NASA Astrophysics Data System (ADS)

    Xu, Yonggang; Yuan, Liming; Zhang, Deyuan

    2016-04-01

    A silicone rubber composite filled with carbonyl iron particles and four different carbonous materials (carbon black, graphite, carbon fiber or multi-walled carbon nanotubes) was prepared using a two-roller mixture. The complex permittivity and permeability were measured using a vector network analyzer at the frequency of 2-18 GHz. Then a type-based mixing rule based on the dielectric absorbent and magnetic absorbent was proposed to reveal the enhancing mechanism on the permittivity and permeability. The enforcement effect lies in the decreased percolation threshold and the changing pending parameter as the carbonous materials were added. The reflection loss (RL) result showed the added carbonous materials enhanced the absorption in the lower frequency range, the RL decrement value being about 2 dB at 4-5 GHz with a thickness of 1 mm. All the added carbonous materials reinforced the shielding effectiveness (SE) of the composites. The maximum increment value of the SE was about 3.23 dB at 0.5 mm and 4.65 dB at 1 mm, respectively. The added carbonous materials could be effective additives for enforcing the absorption and shielding property of the absorbers.

  7. Multi-Absorber Transition-Edge Sensors for X-Ray Astronomy Applications

    NASA Technical Reports Server (NTRS)

    Smith, S. J.; Adams, J. S.; Bandler, S. R.; Busch, S. E.; Chervenak, J. A.; Eckart, M. E.; Ewin, A. J.; Finkbeiner, F. M.; Kelley, R. L.; Kelly, D. P.; hide

    2012-01-01

    We are developing multi-absorber Transition-Edge Sensors (TESs) for applications in x-ray astronomy. These position-sensitive devices consist of multiple x-ray absorbers each with a different thermal coupling to a single readout TES. Heat diffusion between the absorbers and the TES gives rise to a characteristic pulse shape corresponding to each absorber element and enables position discrimination. The development of these detectors is motivated by a desire to maximize focal plane arrays with the fewest number of readout channels. In this contribution we report on the first results from devices consisting of nine) 65 X 65 sq. microns Au x-ray absorbers) 5 microns thick. These are coupled to a single 35 X 35 sq. microns Mo/Au bilayer TES. These devices have demonstrated full-width-half-maximum (FWHM) energy resolution of 2.1 eV at 1.5 keV) 2.5 eV at 5.9 keV and 3.3 eV at 8 keV. This is coupled with position discrimination from pulse shape over the same energy range. We use a finite-element model to reproduce the measured pulse shapes and investigate the detector non-linearity with energy) which impacts on the devices position sensitivity and energy resolution.

  8. Multicenter Analysis of Midterm Clinical Outcomes of Arthroscopic Labral Repair in the Hip: Minimum 5-Year Follow-up.

    PubMed

    Hevesi, Mario; Krych, Aaron J; Johnson, Nick R; Redmond, John M; Hartigan, David E; Levy, Bruce A; Domb, Benjamin G

    2018-02-01

    The technique of hip arthroscopic surgery is advancing and becoming more commonly performed. However, most current reported results are limited to short-term follow-up, and therefore, the durability of the procedure is largely unknown. To perform a multicenter analysis of mid-term clinical outcomes of arthroscopic hip labral repair and determine the risk factors for patient outcomes. Cohort study; Level of evidence, 3. Prospectively collected data of primary hip arthroscopic labral repair performed at 4 high-volume centers between 2008 and 2011 were reviewed retrospectively. Patients were assessed preoperatively and postoperatively with the visual analog scale (VAS), modified Harris Hip Score (mHHS), and Hip Outcome Score-Sports-Specific Subscale (HOS-SSS) at a minimum of 5 years' follow-up. Factors including age, body mass index (BMI), Tönnis grade, and cartilage grade were analyzed in relation to outcome scores, and revision rates were determined. Failure was defined as subsequent ipsilateral hip surgery, including revision arthroscopic surgery and open hip surgery. A total of 303 patients (101 male, 202 female) with a mean age of 32.0 years (range, 10.7-58.9 years) were followed for a mean of 5.7 years (range, 5.0-7.9 years). Patients achieved mean improvements in VAS of 3.5 points, mHHS of 20.1 points, and HOS-SSS of 29.3 points. Thirty-seven patients (12.2%) underwent revision arthroscopic surgery, and 12 (4.0%) underwent periacetabular osteotomy, resurfacing, or total hip arthroplasty during the study period. Patients with a BMI >30 kg/m 2 had a mean mHHS score 9.5 points lower and a mean HOS-SSS score 15.9 points lower than those with a BMI ≤30 kg/m 2 ( P < .01). Patients aged >35 years at surgery had a mean mHHS score 4.5 points lower and a HOS-SSS score 6.7 points lower than those aged ≤35 years ( P = .03). Patients with Tönnis grade 2 radiographs demonstrated a 12.5-point worse mHHS score ( P = .02) and a 23.0-point worse HOS-SSS score ( P < .01

  9. "Smart" Electromechanical Shock Absorber

    NASA Technical Reports Server (NTRS)

    Stokes, Lebarian; Glenn, Dean C.; Carroll, Monty B.

    1989-01-01

    Shock-absorbing apparatus includes electromechanical actuator and digital feedback control circuitry rather than springs and hydraulic damping as in conventional shock absorbers. Device not subject to leakage and requires little or no maintenance. Attenuator parameters adjusted in response to sensory feedback and predictive algorithms to obtain desired damping characteristic. Device programmed to decelerate slowly approaching vehicle or other large object according to prescribed damping characteristic.

  10. The Impact of Post-Procedural Asymmetry, Expansion, and Eccentricity of Bioresorbable Everolimus-Eluting Scaffold and Metallic Everolimus-Eluting Stent on Clinical Outcomes in the ABSORB II Trial.

    PubMed

    Suwannasom, Pannipa; Sotomi, Yohei; Ishibashi, Yuki; Cavalcante, Rafael; Albuquerque, Felipe N; Macaya, Carlos; Ormiston, John A; Hill, Jonathan; Lang, Irene M; Egred, Mohaned; Fajadet, Jean; Lesiak, Maciej; Tijssen, Jan G; Wykrzykowska, Joanna J; de Winter, Robbert J; Chevalier, Bernard; Serruys, Patrick W; Onuma, Yoshinobu

    2016-06-27

    The study sought to investigate the relationship between post-procedural asymmetry, expansion, and eccentricity indices of metallic everolimus-eluting stent (EES) and bioresorbable vascular scaffold (BVS) and their respective impact on clinical events at 1-year follow-up. Mechanical properties of a fully BVS are inherently different from those of permanent metallic stent. The ABSORB II (A bioresorbable everolimus-eluting scaffold versus a metallic everolimus-eluting stent for ischaemic heart disease caused by de-novo native coronary artery lesions) trial compared the BVS and metallic EES in the treatment of a de novo coronary artery stenosis. Protocol-mandated intravascular ultrasound imaging was performed pre- and post-procedure in 470 patients (162 metallic EES and 308 BVS). Asymmetry index (AI) was calculated per lesion as: (1 - minimum scaffold/stent diameter/maximum scaffold/stent diameter). Expansion index and optimal scaffold/stent expansion followed the definition of the MUSIC (Multicenter Ultrasound Stenting in Coronaries) study. Eccentricity index (EI) was calculated as the ratio of minimum and maximum scaffold/stent diameter per cross section. The incidence of device-oriented composite endpoint (DoCE) was collected. Post-procedure, the metallic EES group was more symmetric and concentric than the BVS group. Only 8.0% of the BVS arm and 20.0% of the metallic EES arm achieved optimal scaffold/stent expansion (p < 0.001). At 1 year, there was no difference in the DoCE between both devices (BVS 5.2% vs. EES 3.1%; p = 0.29). Post-procedural devices asymmetry and eccentricity were related to higher event rates while there was no relevance to the expansion status. Subsequent multivariate analysis identified that post-procedural AI >0.30 is an independent predictor of DoCE (hazard ratio: 3.43; 95% confidence interval: 1.08 to 10.92; p = 0.037). BVS implantation is more frequently associated with post-procedural asymmetric and eccentric morphology compared

  11. The cost effectiveness of tacrolimus versus microemulsified cyclosporin: a 10-year model of renal transplantation outcomes.

    PubMed

    Orme, Michelle E; Jurewicz, Wieslaw A; Kumar, Nagappan; McKechnie, Tracy L

    2003-01-01

    In 1983, the launch of cyclosporin was a significant clinical advance for organ transplant recipients. Subsequent drug research led to further advances with the introduction of cyclosporin microemulsion (cyclosporin ME) and tacrolimus. This paper presents the results from a long-term model comparing the clinical and economic outcomes associated with cyclosporin ME and tacrolimus immunosuppression for the prevention of graft rejection following renal transplantation. A model was developed to project the costs and outcomes over a 10-year period following transplantation. The model was based on the results of a prospective, randomised study of 179 renal transplantation recipients receiving either cyclosporin ME or tacrolimus, which was conducted by the Welsh Transplantation Research Group (median follow-up: 2.7 years). The short-term costs and outcomes were the averages from the actual head-to-head trial data. From this, the long-term costs and outcomes were extrapolated based on the rate of change in patient and graft survival at 3, 5 and 10 years post transplant, as reported in the 1995 United Kingdom Transplant Support Service Authority Renal Transplant Audit. PERSPECTIVE AND YEAR OF COST DATA: The analysis was conducted from the perspective of a UK transplant unit. Costs were at 1999 prices (pounds sterling 1 = dollars US 1.42 = Euro 1.5) and costs and outcomes were discounted at 6% and 1.5%, respectively. The model estimated that 10 years after transplantation, the proportion of patients surviving was 56% of the cyclosporin ME cohort and 64% of the tacrolimus cohort. The cumulative cost of maintenance therapy at 10 years was pounds sterling 23204 per patient maintained on cyclosporin ME versus pounds sterling 23803 per patient on tacrolimus. The cost per survivor at 10 years was pounds sterling 37000 (tacrolimus) versus pounds sterling 41000 (cyclosporin ME) and the cost per patient with a functioning graft was pounds sterling 39000 versus pounds sterling 45000

  12. Twenty Years of MALL Project Implementation: A Meta-Analysis of Learning Outcomes

    ERIC Educational Resources Information Center

    Burston, Jack

    2015-01-01

    Despite the hundreds of Mobile-Assisted Language Learning (MALL) publications over the past twenty years, statistically reliable measures of learning outcomes are few and far between. In part, this is due to the fact that well over half of all MALL-related studies report no objectively quantifiable learning outcomes, either because they did not…

  13. Optimization of Sound Absorbers Number and Placement in an Enclosed Room by Finite Element Simulation

    NASA Astrophysics Data System (ADS)

    Lau, S. F.; Zainulabidin, M. H.; Yahya, M. N.; Zaman, I.; Azmir, N. A.; Madlan, M. A.; Ismon, M.; Kasron, M. Z.; Ismail, A. E.

    2017-10-01

    Giving a room proper acoustic treatment is both art and science. Acoustic design brings comfort in the built environment and reduces noise level by using sound absorbers. There is a need to give a room acoustic treatment by installing absorbers in order to decrease the reverberant sound. However, they are usually high in price which cost much for installation and there is no system to locate the optimum number and placement of sound absorbers. It would be a waste if the room is overly treated with absorbers or cause improper treatment if the room is treated with insufficient absorbers. This study aims to determine the amount of sound absorbers needed and optimum location of sound absorbers placement in order to reduce the overall sound pressure level in specified room by using ANSYS APDL software. The size of sound absorbers needed is found to be 11 m 2 by using Sabine equation and different unit sets of absorbers are applied on walls, each with the same total areas to investigate the best configurations. All three sets (single absorber, 11 absorbers and 44 absorbers) has successfully treating the room by reducing the overall sound pressure level. The greatest reduction in overall sound pressure level is that of 44 absorbers evenly distributed around the walls, which has reduced as much as 24.2 dB and the least effective configuration is single absorber whereby it has reduced the overall sound pressure level by 18.4 dB.

  14. Neurodevelopmental outcome at two years of age after general and awake-regional anaesthesia in infancy: a randomised controlled trial

    PubMed Central

    Davidson, Andrew J.; Disma, Nicola; de Graaff, Jurgen C.; Withington, Davinia E.; Dorris, Liam; Bell, Graham; Stargatt, Robyn; Bellinger, David C.; Schuster, Tibor; Arnup, Sarah J.; Hardy, Pollyanna; Hunt, Rodney W.; Takagi, Michael J.; Giribaldi, Gaia; Hartmann, Penelope L.; Salvo, Ida; Morton, Neil S.; von Ungern Sternberg, Britta S; Locatelli, Bruno Guido; Wilton, Niall; Lynn, Anne; Thomas, Joss J.; Polaner, David; Bagshaw, Oliver; Szmuk, Peter; Absalom, Anthony R.; Frawley, Geoff; Berde, Charles; Ormond, Gillian D; Marmor, Jacki; Ellen, Mary

    2016-01-01

    Summary Background There is pre-clinical evidence that general anaesthetics affect brain development. There is mixed evidence from cohort studies that young children exposed to anaesthesia may have an increased risk of poorer neurodevelopmental outcome. This trial aims to determine if GA in infancy has any impact on neurodevelopmental outcome. The primary outcome for the trial is neurodevelopmental outcome at 5 years of age. The secondary outcome is neurodevelopmental outcome at two years of age and is reported here. Methods We performed an international assessor-masked randomised controlled equivalence trial in infants less than 60 weeks post-menstrual age, born at greater than 26 weeks gestational age having inguinal herniorrhaphy. Infants were excluded if they had existing risk factors for neurologic injury. Infants were randomly assigned to awake-regional (RA) or sevoflurane-based general anaesthesia (GA). Web-based randomisation was performed in blocks of two or four and stratified by site and gestational age at birth. The outcome for analysis was the composite cognitive score of the Bayley Scales of Infant and Toddler Development, Third Edition. The analysis was as-per-protocol adjusted for gestational age at birth. A difference in means of five points (1/3 SD) was predefined as the clinical equivalence margin. The trial was registered at ANZCTR, ACTRN12606000441516 and ClinicalTrials.gov, NCT00756600. Findings Between February 2007, and January 2013, 363 infants were randomised to RA and 359 to GA. Outcome data were available for 238 in the RA and 294 in the GA arms. The median duration of anaesthesia in the GA arm was 54 minutes. For the cognitive composite score there was equivalence in means between arms (RA-GA: +0·169, 95% CI −2·30 to +2·64). Interpretation For this secondary outcome we found no evidence that just under an hour of sevoflurane anaesthesia in infancy increases the risk of adverse neurodevelopmental outcome at two years of age compared

  15. Surgical decompression for space-occupying cerebral infarction: outcomes at 3 years in the randomized HAMLET trial.

    PubMed

    Geurts, Marjolein; van der Worp, H Bart; Kappelle, L Jaap; Amelink, G Johan; Algra, Ale; Hofmeijer, Jeannette

    2013-09-01

    We assessed whether the effects of surgical decompression for space-occupying hemispheric infarction, observed at 1 year, are sustained at 3 years. Patients with space-occupying hemispheric infarction, who were enrolled in the Hemicraniectomy After Middle cerebral artery infarction with Life-threatening Edema Trial within 4 days after stroke onset, were followed up at 3 years. Outcome measures included functional outcome (modified Rankin Scale), death, quality of life, and place of residence. Poor functional outcome was defined as modified Rankin Scale >3. Of 64 included patients, 32 were randomized to decompressive surgery and 32 to best medical treatment. Just as at 1 year, surgery had no effect on the risk of poor functional outcome at 3 years (absolute risk reduction, 1%; 95% confidence interval, -21 to 22), but it reduced case fatality (absolute risk reduction, 37%; 95% confidence interval, 14-60). Sixteen surgically treated patients and 8 controls lived at home (absolute risk reduction, 27%; 95% confidence interval, 4-50). Quality of life improved between 1 and 3 years in patients treated with surgery. In patients with space-occupying hemispheric infarction, the effects of decompressive surgery on case fatality and functional outcome observed at 1 year are sustained at 3 years. http://www.controlled-trials.com. Unique identifier: ISRCTN94237756.

  16. Management of comminuted patellar fracture with non-absorbable suture cerclage and Nitinol patellar concentrator.

    PubMed

    Lue, Tan Hong; Feng, Liu Wei; Jun, Wang Ming; Yin, Li Wu

    2014-12-01

    To evaluate the effectiveness and safety of a fixation technique for comminuted patellar fracture using non-absorbable suture cerclage and nickel-titanium patellar concentrator (Ni-Ti PC). Twenty-nine consecutive patients with displaced comminuted patellar fractures accepted internal fixation procedure using Ni-Ti PC augmented with different types of non-absorbable suture cerclage. During follow-up, the clinical grading scales of Böstman, including range of movement, pain, work, atrophy, assistance in walking, effusion, giving way, and stair-climbing, were used to evaluate the clinical results. Complications including implant loosening, fragment displacement, bone nonunion, infection, breakage of the implants, painful hardware, and post-traumatic osteoarthritis were also assessed. Patients were followed up for a mean period of 27 months. The bone union radiographically occurred approximately 2.5 months without implant loosening and fragment displacement. According to Böstman method, satisfactory results were obtained, and the mean score at final follow-up was 28 (range 20–30) points. Twenty-two patients with excellent results had mean score of 29.8 ± 0.5 (range 28–30) and seven patients with good results had mean score of 22.7 ± 3.14 (range 20–27). No postoperative complications, such as infection, dislocation, breakage of the implants, painful hardware, and post-traumatic osteoarthritis, were observed. Ni-Ti PC fixation with non-absorbable suture cerclage is a feasible approach for comminuted patellar fractures. Firm fixation with this technique resulted in satisfactory outcomes without obvious complications.

  17. Aldehyde-containing urea-absorbing polysaccharides

    NASA Technical Reports Server (NTRS)

    Mueller, W. A.; Hsu, G. C.; Marsh, H. E., Jr. (Inventor)

    1977-01-01

    A novel aldehyde containing polymer (ACP) is prepared by reaction of a polysaccharide with periodate to introduce aldehyde groups onto the C2 - C3 carbon atoms. By introduction of ether and ester groups onto the pendant primary hydroxyl solubility characteristics are modified. The ACP is utilized to absorb nitrogen bases such as urea in vitro or in vivo.

  18. A Rights-Based Sexuality Education Curriculum for Adolescents: 1-Year Outcomes From a Cluster-Randomized Trial.

    PubMed

    Rohrbach, Louise A; Berglas, Nancy F; Jerman, Petra; Angulo-Olaiz, Francisca; Chou, Chih-Ping; Constantine, Norman A

    2015-10-01

    The purpose of this study was to evaluate the impact of a rights-based sexuality education curriculum on adolescents' sexual health behaviors and psychosocial outcomesyear after participation. Within 10 urban high schools, ninth-grade classrooms were randomized to receive a rights-based curriculum or a basic sex education (control) curriculum. The intervention was delivered across two school years (2011-2012, 2012-2013). Surveys were completed by 1,447 students at pretest and 1-year follow-up. Multilevel analyses examined curriculum effects on behavioral and psychosocial outcomes, including four primary outcomes: pregnancy risk, sexually transmitted infection risk, multiple sexual partners, and use of sexual health services. Students receiving the rights-based curriculum had higher scores than control curriculum students on six of nine psychosocial outcomes, including sexual health knowledge, attitudes about relationship rights, partner communication, protection self-efficacy, access to health information, and awareness of sexual health services. These students also were more likely to report use of sexual health services (odds ratio, 1.37; 95% confidence interval, 1.05-1.78) and more likely to be carrying a condom (odds ratio, 1.97; 95% confidence interval, 1.39-2.80) relative to those receiving the control curriculum. No effects were found for other sexual health behaviors, possibly because of low prevalence of sexual activity in the sample. The curriculum had significant, positive effects on psychosocial and some behavioral outcomesyear later, but it might not be sufficient to change future sexual behaviors among younger adolescents, most of whom are not yet sexually active. Booster education sessions might be required throughout adolescence as youth initiate sexual relationships. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  19. Clinicopathological, functional, and immediate oncologic outcome assessment in men aged≤50 years with prostate cancer after robotic prostatectomy.

    PubMed

    Samadi, David B; Sebrow, Dov; Hobbs, Adele R; Bernstein, Adrien N; Brajtbord, Jonathan; Lavery, Hugh J; Jazayeri, Seyed Behzad

    2017-01-01

    To define the pathologic and functional outcomes of men 50 years of age and younger with prostate cancer in a contemporary robotic cohort, this study was designed. Patients undergoing robotic-assisted laparoscopic prostatectomy from April 2002 to April 2012 (n = 2,495) formed the base population for the current analyses. The patients were dichotomized according to their age≤50 (n = 271) and>50-year-old (n = 2,224). Clinicopathological and health-related quality-of-life outcomes were recorded and analyzed for differences. Propensity score matching was used when assessing urinary and sexual function outcome. Baseline prostate-specific antigen and clinical stage were similar between men older than 50 years and those younger. Younger patients had less severe disease (D׳Amico risk and Gleason scores) and smaller prostates. Young men had higher rates of erectile function at all time points, including baseline (94% vs. 83% at 12mo, P <0.01). Continence was similar at all time points except for 6 months, where younger patients experienced a faster return than older patients and then remained constant, while older patients continued to improve (96% vs. 89%, P<0.01). After matching process, the difference in erectile function at 6-month follow-up was lost. Most men aged 50 years and younger who received robotic-assisted laparoscopic prostatectomy had clinically significant prostate cancer. Although histopathologic and short-term oncologic outcomes were nearly identical when compared to older patients, younger men had a more rapid and superior return of erectile function. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Design and measuring of a tunable hybrid metamaterial absorber for terahertz frequencies

    NASA Astrophysics Data System (ADS)

    Zhong, Min; Liu, Shui Jie; Xu, Bang Li; Wang, Jie; Huang, Hua Qing

    2018-04-01

    A tunable hybrid metamaterial absorber is designed and experimentally produced in THz band. The hybrid metamaterial absorber contains two dielectric layers: SU-8 and VO2 layers. An absorption peak reaching to 83.5% is achieved at 1.04 THz. The hybrid metamaterial absorber exhibits high absorption when the incident angle reaches to 45°. Measured results indicate that the absorption amplitude and peak frequency of the hybrid metamaterial absorber is tunable in experiments. It is due to the insulator-to-metal phase transition is achieved when the measured temperature reaches to 68 °C. Moreover, the hybrid metamaterial absorber reveals high figure of merit (FOM) value when the measured temperature reaches to 68 °C.

  1. Comparison of Outcomes of Acute Coronary Syndrome in Patients ≥80 Years Versus Those <80 Years in Israel from 2000 to 2013.

    PubMed

    Shechter, Michael; Rubinstein, Roy; Goldenberg, Ilan; Matetzki, Shlomi

    2017-10-15

    Although patients ≥80 years old constitute the fastest-growing segment of the population and have a high prevalence of coronary artery disease, few data exist regarding the outcome of octogenarians with acute coronary syndrome (ACS). In a retrospective study based on data of 13,432 ACS patients who were enrolled in the ACS Israel Survey, we first evaluated the clinical outcome of 1,731 ACS patients ≥80 years (13%) compared with 11,701 ACS patients <80 years (87%) hospitalized during 2000 to 2013. Second, we evaluated the clinical outcome of patients ≥80 years hospitalized during the 2000 to 2006 ("early") period (n = 1,037) compared with those of the same age group of patients hospitalized during the 2008 to 2013 ("late") period (n = 694). Implementation of the ACS AHA/ACC/ESC therapeutic guidelines was lower in ACS patients ≥80 years compared with patients <80 years. Multivariate Cox regression analysis demonstrated a worse 1-year survival rate in the ACS patients ≥80 years compared with those <80 years. During the late period, patients ≥80 years were more frequently treated with guideline-recommended therapies compared with patients from the same age group who were hospitalized in the early period. Multivariate Cox regression analysis demonstrated a better 1-year survival rate of patients ≥80 years during the late period compared with the early period (hazard ratio 1.17, 95% confidence interval 1.15 to 1.61; p = 0.01). In addition, adverse outcome rates of ACS patients ≥80 years were significantly higher compared with those of patients <80 years. However, survival rates of ACS patients ≥80 years were improved over the 200 to 2013 period. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. One-year outcomes of a treat-and-extend regimen of intravitreal aflibercept for polypoidal choroidal vasculopathy.

    PubMed

    Hosokawa, Mio; Morizane, Yuki; Hirano, Masayuki; Kimura, Shuhei; Kumase, Fumiaki; Shiode, Yusuke; Doi, Shinichiro; Toshima, Shinji; Hosogi, Mika; Fujiwara, Atsushi; Mitsuhashi, Toshiharu; Shiraga, Fumio

    2017-03-01

    To evaluate the 1-year treatment outcomes of intravitreal aflibercept injections (IVA) using a treat-and-extend regimen for polypoidal choroidal vasculopathy (PCV). Thirty-seven eyes with treatment-naive PCV treated with IVA using a treat-and-extend regimen for 1 year were reviewed retrospectively. The main outcome measures were changes in the best-corrected visual acuity (BCVA) and central retinal thickness (CRT), and the treatment interval at 1 year. The predictive factors for patients who could not continue to extend the treatment interval because of poor response to IVA or recurrence were analyzed. The mean logarithm of the minimum angle of resolution BCVA improved from 0.37 at baseline to 0.21 at 1 year (P < 0.001). The mean CRT decreased from 342.3 μm at baseline to 196.6 μm at 1 year (P < 0.001). The mean treatment interval was 9.7 weeks at 1 year (4 weeks in 11 eyes [29.7%], 6 weeks in 1 eye [2.7%], 8 weeks in 2 eyes [5.4%], 10 weeks in 1 eye [2.7%], and 12 weeks in 22 eyes [59.5%]). A larger number of polypoidal lesions at baseline was predictive for patients who could not continue to extend the treatment interval. IVA using a treat-and-extend regimen is effective for improving BCVA and CRT in eyes with PCV.

  3. Long-term Outcomes After Ulnar Collateral Ligament Reconstruction in Competitive Baseball Players: Minimum 10-Year Follow-up.

    PubMed

    Osbahr, Daryl C; Cain, E Lyle; Raines, B Todd; Fortenbaugh, Dave; Dugas, Jeffrey R; Andrews, James R

    2014-06-01

    Ulnar collateral ligament reconstruction (UCLR) has afforded baseball players with excellent results; however, previous studies have described only short-term outcomes. To evaluate long-term outcomes after UCLR in baseball players. Case series; Level of evidence, 4. All UCLRs performed on competitive baseball players with a minimum 10-year follow-up were identified. Surgical data were collected prospectively and patients were surveyed by telephone follow-up, during which scoring systems were used to assess baseball career and post-baseball career outcomes. Of 313 patients, 256 (82%) were contacted at an average of 12.6 years; 83% of these baseball players (90% pitchers) were able to return to the same or higher level of competition in less than 1 year, but results varied according to preoperative level of play. Baseball career longevity was 3.6 years in general and 2.9 years at the same or higher level of play, but major and minor league players returned for longer than did collegiate and high school players after surgery (P < .001). Baseball retirement typically occurred for reasons other than elbow problems (86%). Many players had shoulder problems (34%) or surgery (25%) during their baseball career, and these occurrences most often resulted in retirement attributable to shoulder problems (P < .001). For post-baseball career outcomes, 92% of patients were able to throw without pain, and 98% were still able to participate in throwing at least on a recreational level. The 10-year minimum follow-up scores (mean ± standard deviation) for the Disabilities of the Arm, Shoulder and Hand (DASH), DASH work module, and DASH sports module were 0.80 ± 4.43, 1.10 ± 6.90, and 2.88 ± 11.91, respectively. Overall, 93% of patients were satisfied, with few reports of persistent elbow pain (3%) or limitation of function (5%). Long-term follow-up of UCLRs in baseball players indicates that most patients were satisfied, with few reports of persistent elbow pain or limitation of

  4. Dynamic testing of airplane shock-absorbing struts

    NASA Technical Reports Server (NTRS)

    Langer, P; Thome, W

    1932-01-01

    Measurement of perpendicular impacts of a landing gear with different shock-absorbing struts against the drum testing stand. Tests were made with pneumatic shock absorbers having various degrees of damping, liquid shock absorbers, steel-spring shock absorbers and rigid struts. Falling tests and rolling tests. Maximum impact and gradual reduction of the impacts in number and time in the falling tests. Maximum impact and number of weaker impacts in rolling tests.

  5. Three-year chemical dependency and mental health treatment outcomes among adolescents: the role of continuing care.

    PubMed

    Sterling, Stacy; Chi, Felicia; Campbell, Cynthia; Weisner, Constance

    2009-08-01

    Few studies have examined the effects of treatment factors, including the types of services [chemical dependency (CD), psychiatric, or both], on long-term outcomes among adolescents following CD treatment, and whether receiving continuing care may contribute to better outcomes. This study examines the effect of the index CD and ongoing CD and psychiatric treatment episodes, 12-step participation, and individual characteristics such as CD and mental health (MH) severity and gender, age, and ethnicity, on 3-year CD and MH outcomes. Participants were 296 adolescents aged 13 to 18 seeking treatment at 4 CD programs of a nonprofit, managed care, integrated health system. We surveyed participants at intake, 1 year, and 3 years, and examined survey and administrative data, and CD and psychiatric utilization. At 3 years, 29.7% of the sample reported total abstinence from both alcohol and drugs (excluding tobacco). Compared with girls, boys had only half the odds of being abstinent (OR = 0.46, p = 0.0204). Gender also predicted Externalizing severity at 3 years (coefficients 18.42 vs. 14.77, p < 0.01). CD treatment readmission in the second and third follow-up years was related to abstinence at 3 years (OR = 0.24, p = 0.0066 and OR = 3.33, p = 0.0207, respectively). Abstinence at 1 year predicted abstinence at 3 years (OR = 4.11, p < 0.0001). Those who were abstinent at 1 year also had better MH outcomes (both lower Internalizing and Externalizing scores) than those who were not (11.75 vs. 15.55, p = 0.0012 and 15.13 vs. 18.06, p = 0.0179, respectively). A CD treatment episode resulting in good 1-year CD outcomes may contribute significantly to both CD and MH outcomes 3 years later. The findings also point to the value of providing a continuing care model of treatment for adolescents.

  6. Impedance approach to designing efficient vibration energy absorbers

    NASA Astrophysics Data System (ADS)

    Bobrovnitskii, Y. I.; Morozov, K. D.; Tomilina, T. M.

    2017-03-01

    The concept introduced previously by the authors on the best sound absorber having the maximum allowable efficiency in absorbing the energy of an incident sound field has been extended to arbitrary linear elastic media and structures. Analytic relations have been found for the input impedance characteristics that the best vibrational energy absorber should have. The implementation of these relations is the basis of the proposed impedance method of designing efficient vibration and noise absorbers. We present the results of a laboratory experiment that confirms the validity of the obtained theoretical relations, and we construct the simplest best vibration absorber. We also calculate the parameters and demonstrate the efficiency of a dynamic vibration absorber as the best absorber.

  7. An Overview on Impact Behaviour and Energy Absorption of Collapsible Metallic and Non-Metallic Energy Absorbers used in Automotive Applications

    NASA Astrophysics Data System (ADS)

    Shinde, R. B.; Mali, K. D.

    2018-04-01

    Collapsible impact energy absorbers play an important role of protecting automotive components from damage during collision. Collision of the two objects results into the damage to one or both of them. Damage may be in the form of crack, fracture and scratch. Designers must know about how the material and object behave under impact event. Owing to above reasons different types of collapsible impact energy absorbers are developed. In the past different studies were undertaken to improve such collapsible impact energy absorbers. This article highlights such studies on common shapes of collapsible impact energy absorber and their impact behaviour under the axial compression. The literature based on studies and analyses of effects of different geometrical parameters on the crushing behaviour of impact energy absorbers is presented in detail. The energy absorber can be of different shape such as circular tube, square tube, and frustums of cone and pyramids. The crushing behaviour of energy absorbers includes studies on crushing mechanics, modes of deformation, energy absorbing capacity, effect on peak and mean crushing load. In this work efforts are made to cover major outcomes from past studies on such behavioural parameters. Even though the major literature reviewed is related to metallic energy absorbers, emphasis is also laid on covering literature on use of composite tube, fiber metal lamination (FML) member, honeycomb plate and functionally graded thickness (FGT) tube as a collapsible impact energy absorber.

  8. Indications and Outcomes of Endoscopic CO2 Laser Cricopharyngeal Myotomy

    PubMed Central

    Bergeron, Jennifer L.; Chhetri, Dinesh K.

    2015-01-01

    Objectives/Hypothesis To describe indications, management, and outcomes of endoscopic CO2 laser cricopharyngeal myotomy (CPM). Study Design Case series with chart review. Methods All patients treated with endoscopic CO2 laser CPM over a 6-year period were identified. A retrospective chart review was performed for surgical indication, history and physical examinations, and swallow evaluations. Swallowing outcomes were assessed using the Functional Outcome Swallowing Scale (FOSS); findings were compared across groups. Results Eighty-seven patients underwent endoscopic CO2 laser CPM during the study period for cricopharyngeal dysfunction. Indications included Zenker’s diverticulum (ZD) (39), DiGeorge syndrome (two), stroke (five), nerve injury (two), radiation for head and neck cancer (15), idiopathic (16), hyperfunctional tracheoesophageal speech (five) and dysphagia from cricopharyngeus stricture after laryngectomy (three). Mean, median, and mode time to feeding postoperatively were 1.4, 1, and 0 days respectively. Mean, median, and mode hospital stays were 1.8, 1, and 1 day respectively. Overall, FOSS scores improved from 2.6 to 1.6 (P < .001). Improvement was greatest for patients with ZD (2.4 to 1.0) and cricopharyngeal dysfunction from nerve injury (3.3 to 1.8) and least for those with prior radiation (3.9 to 3.2). All patients undergoing CPM for poor tracheoesophageal speech regained speech postoperatively. No patients developed mediastinitis, abscess, or fistula. Conclusions Endoscopic CO2 laser CPM is a safe treatment for cricopharyngeal dysfunction of various causes, though swallowing outcomes may vary depending on the surgical indication. Early feeding postoperatively after CPM is safe and facilitates early hospital discharge. PMID:24114581

  9. Ten-Year Recovery Outcomes for Clients With Co-Occurring Schizophrenia and Substance Use Disorders

    PubMed Central

    Drake, Robert E.; McHugo, Gregory J.; Xie, Haiyi; Fox, Melinda; Packard, Joan; Helmstetter, Barbara

    2006-01-01

    The long-term courses of people with schizophrenia and of those with substance use disorder have been studied separately and extensively. The long-term course of clients with co-occurring schizophrenic and substance use disorders has, however, not been examined. This article reports 10-year outcomes for 130 clients with co-occurring schizophrenic and substance use disorders in the New Hampshire Dual Diagnosis Study. In addition, we report on 6 “recovery outcomes,” identified by dual diagnosis clients, as examples of positive coping behaviors. Longitudinal data were modeled using generalized estimating equation (GEE) methods. Participants improved steadily over 10 years in the outcome domains of symptoms, substance abuse, institutionalization, functional status, and quality of life. Further, at the 10-year follow-up, substantial proportions were above cutoffs selected by dual diagnosis clients as indicators of recovery: 62.7% were controlling symptoms of schizophrenia; 62.5% were actively attaining remissions from substance abuse; 56.8% were in independent living situations; 41.4% were competitively employed; 48.9% had regular social contacts with non–substance abusers; and 58.3% expressed overall life satisfaction. These 6 outcomes were only weakly interrelated over time, suggesting that recovery, as defined by clients, is a multidimensional concept. Overall, the 10-year findings on recovery outcomes provide a hopeful long-term perspective for dual diagnosis clients. PMID:16525088

  10. Ten-year recovery outcomes for clients with co-occurring schizophrenia and substance use disorders.

    PubMed

    Drake, Robert E; McHugo, Gregory J; Xie, Haiyi; Fox, Melinda; Packard, Joan; Helmstetter, Barbara

    2006-07-01

    The long-term courses of people with schizophrenia and of those with substance use disorder have been studied separately and extensively. The long-term course of clients with co-occurring schizophrenic and substance use disorders has, however, not been examined. This article reports 10-year outcomes for 130 clients with co-occurring schizophrenic and substance use disorders in the New Hampshire Dual Diagnosis Study. In addition, we report on 6 "recovery outcomes," identified by dual diagnosis clients, as examples of positive coping behaviors. Longitudinal data were modeled using generalized estimating equation (GEE) methods. Participants improved steadily over 10 years in the outcome domains of symptoms, substance abuse, institutionalization, functional status, and quality of life. Further, at the 10-year follow-up, substantial proportions were above cutoffs selected by dual diagnosis clients as indicators of recovery: 62.7% were controlling symptoms of schizophrenia; 62.5% were actively attaining remissions from substance abuse; 56.8% were in independent living situations; 41.4% were competitively employed; 48.9% had regular social contacts with non-substance abusers; and 58.3% expressed overall life satisfaction. These 6 outcomes were only weakly interrelated over time, suggesting that recovery, as defined by clients, is a multidimensional concept. Overall, the 10-year findings on recovery outcomes provide a hopeful long-term perspective for dual diagnosis clients.

  11. Neoatherosclerosis 5 Years After Bioresorbable Vascular Scaffold Implantation.

    PubMed

    Moriyama, Noriaki; Shishido, Koki; Tanaka, Yutaka; Yokota, Shohei; Hayashi, Takahiro; Miyashita, Hirokazu; Koike, Tatsuya; Yokoyama, Hiroaki; Takada, Takuma; Nishimoto, Takashi; Ochiai, Tomoki; Tobita, Kazuki; Yamanaka, Futoshi; Mizuno, Shingo; Murakami, Masato; Takahashi, Saeko; Saito, Shigeru

    2018-05-01

    Data regarding neoatherosclerosis after everolimus-eluting bioresorbable vascular scaffold (BVS) (ABSORB BVS Rev. 1.1, Abbott Vascular, Santa Clara, California) implantation are limited. This study investigated the findings of neoatherosclerosis at 5 years after BVS 1.1 implantation by using multi-imaging modalities, including optical coherence tomography (OCT). Patients included in the ABSORB EXTEND (ABSORB EXTEND Clinical Investigation) trial at Shonan Kamakura General Hospital underwent OCT at baseline after the index procedure and at 1 and 5 years. Intimal plaque distributions in the in-scaffold and out-scaffold segments were analyzed. Twenty patients (22 lesions) with stable angina pectoris were enrolled. The median follow-up duration was 67 months (interquartile range: 65 to 69 months), and the mean age was 69 ± 8 years. Patients with diabetes mellitus (25%) were included. Based on the baseline angiogram, 10 (46%) lesions were type B2/C lesions. At 1 and 5 years of follow-up, significant differences in the prevalence of in-scaffold lipid-laden neointima (17% vs. 61%; p = 0.04), calcification (28% vs. 94%; p < 0.01), neovascularization (6% vs. 78%; p < 0.01), and thin-cap fibroatheroma (0% vs. 22%; p = 0.02) were found. In the out-scaffold segments, no significant difference in the plaque prevalence between 1 and 5 years was noted. The occurrence and progression of in-scaffold neoatherosclerosis with luminal narrowing was observed at 5 years after BVS 1.1 implantation. The small size of the current study warrants confirmation in larger study. (ABSORB EXTEND Clinical Investigation [ABSORB EXTEND]; NCT01023789). Copyright © 2018 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  12. Lightweight NiFe2O4 with controllable 3D network structure and enhanced microwave absorbing properties

    NASA Astrophysics Data System (ADS)

    Wang, Fen; Wang, Xing; Zhu, Jianfeng; Yang, Haibo; Kong, Xingang; Liu, Xiao

    2016-11-01

    3D network structure NiFe2O4 was successfully synthesized by a templated salt precipitation method using PMMA colloid crystal as templates. The morphology, phase composition and microwave absorbing properties of as-prepared samples were characterized by scanning electron microscopy (SEM), X-ray diffraction (XRD), vector network analyzer (VNA), and so on. The results revealed that the 3D network structure was configurated with smooth spherical walls composed of NiFe2O4 nanocrystals and their pore diameters being in the range of 80-250 nm. The microwave absorption properties of the 3D network structure NiFe2O4 were crucially determined by the special structure. The synergy of intrinsic magnetic loss of magnetic NiFe2O4 and the interfacial polarization enhanced by 3D network structure and the interaction of multiple mechanisms endowed the sample with the feature of strong absorption, broad bandwidth and lightweight. There is more than one valley in the reflection loss curves and the maximum reflection loss is 27.5 dB with a bandwidth of 4 GHz. Moreover, the 3D network structure NiFe2O4 show a greater reflection loss with the same thickness comparing to the ordinary NiFe2O4 nanoparticles, which could achieve the feature of lightweight of the microwave absorbing materials.

  13. Lightweight NiFe2O4 with controllable 3D network structure and enhanced microwave absorbing properties

    PubMed Central

    Wang, Fen; Wang, Xing; Zhu, Jianfeng; Yang, Haibo; Kong, Xingang; Liu, Xiao

    2016-01-01

    3D network structure NiFe2O4 was successfully synthesized by a templated salt precipitation method using PMMA colloid crystal as templates. The morphology, phase composition and microwave absorbing properties of as-prepared samples were characterized by scanning electron microscopy (SEM), X-ray diffraction (XRD), vector network analyzer (VNA), and so on. The results revealed that the 3D network structure was configurated with smooth spherical walls composed of NiFe2O4 nanocrystals and their pore diameters being in the range of 80–250 nm. The microwave absorption properties of the 3D network structure NiFe2O4 were crucially determined by the special structure. The synergy of intrinsic magnetic loss of magnetic NiFe2O4 and the interfacial polarization enhanced by 3D network structure and the interaction of multiple mechanisms endowed the sample with the feature of strong absorption, broad bandwidth and lightweight. There is more than one valley in the reflection loss curves and the maximum reflection loss is 27.5 dB with a bandwidth of 4 GHz. Moreover, the 3D network structure NiFe2O4 show a greater reflection loss with the same thickness comparing to the ordinary NiFe2O4 nanoparticles, which could achieve the feature of lightweight of the microwave absorbing materials. PMID:27897209

  14. Ultra-thin and -broadband microwave magnetic absorber enhanced by phase gradient metasurface incorporation

    NASA Astrophysics Data System (ADS)

    Fan, Ya; Wang, Jiafu; Li, Yongfeng; Pang, Yongqiang; Zheng, Lin; Xiang, Jiayu; Zhang, Jieqiu; Qu, Shaobo

    2018-05-01

    Based on the effect of anomalous reflection and refraction caused by the circularly cross-polarized phase gradient metasurface (PGM), an ultra-thin and -broadband composite absorber composed of metasurface and conventional magnetic absorbing film is proposed and demonstrated in this paper. In the case of keeping nearly the same thickness of absorbing layer, the equivalent thickness of magnetic absorbing film is enlarged by the effect of anomalous reflection and refraction, resulting in the expansion and improvement of the absorbing bandwidth and efficiency in low microwave frequency. A biarc metallic sub-cell for circularly crossed polarization is adopted to form a broadband phase gradient, by the means of rotating the Pancharatnam–Berry phases. As indicated in the experimental results, the fabricated 3.6 mm-thick absorber can averagely absorb microwave energy with the specular reflection below  ‑10 dB in the frequency interval of 2–12 GHz, which shows a good match with simulated results. Due to ultra-thin thickness and ultra-wide operating bandwidth, the proposed application of PGM in absorbing can provide an alternative way to enhance the absorbing property of current absorbing materials.

  15. Characterization of selective solar absorber under high vacuum.

    PubMed

    Russo, Roberto; Monti, Matteo; di Giamberardino, Francesco; Palmieri, Vittorio G

    2018-05-14

    Total absorption and emission coefficients of selective solar absorbers are measured under high vacuum conditions from room temperature up to stagnation temperature. The sample under investigation is illuminated under vacuum @1000W/m 2 and the sample temperature is recorded during heat up, equilibrium and cool down. During stagnation, the absorber temperature exceeds 300°C without concentration. Data analysis allows evaluating the solar absorptance and thermal emittance at different temperatures. These in turn are useful to predict evacuated solar panel performances at operating conditions.

  16. Self-assembly of highly efficient, broadband plasmonic absorbers for solar steam generation.

    PubMed

    Zhou, Lin; Tan, Yingling; Ji, Dengxin; Zhu, Bin; Zhang, Pei; Xu, Jun; Gan, Qiaoqiang; Yu, Zongfu; Zhu, Jia

    2016-04-01

    The study of ideal absorbers, which can efficiently absorb light over a broad range of wavelengths, is of fundamental importance, as well as critical for many applications from solar steam generation and thermophotovoltaics to light/thermal detectors. As a result of recent advances in plasmonics, plasmonic absorbers have attracted a lot of attention. However, the performance and scalability of these absorbers, predominantly fabricated by the top-down approach, need to be further improved to enable widespread applications. We report a plasmonic absorber which can enable an average measured absorbance of ~99% across the wavelengths from 400 nm to 10 μm, the most efficient and broadband plasmonic absorber reported to date. The absorber is fabricated through self-assembly of metallic nanoparticles onto a nanoporous template by a one-step deposition process. Because of its efficient light absorption, strong field enhancement, and porous structures, which together enable not only efficient solar absorption but also significant local heating and continuous stream flow, plasmonic absorber-based solar steam generation has over 90% efficiency under solar irradiation of only 4-sun intensity (4 kW m(-2)). The pronounced light absorption effect coupled with the high-throughput self-assembly process could lead toward large-scale manufacturing of other nanophotonic structures and devices.

  17. Composite neutron absorbing coatings for nuclear criticality control

    DOEpatents

    Wright, Richard N.; Swank, W. David; Mizia, Ronald E.

    2005-07-19

    Thermal neutron absorbing composite coating materials and methods of applying such coating materials to spent nuclear fuel storage systems are provided. A composite neutron absorbing coating applied to a substrate surface includes a neutron absorbing layer overlying at least a portion of the substrate surface, and a corrosion resistant top coat layer overlying at least a portion of the neutron absorbing layer. An optional bond coat layer can be formed on the substrate surface prior to forming the neutron absorbing layer. The neutron absorbing layer can include a neutron absorbing material, such as gadolinium oxide or gadolinium phosphate, dispersed in a metal alloy matrix. The coating layers may be formed by a plasma spray process or a high velocity oxygen fuel process.

  18. Study the Characterization of Spectral Absorbance on Irradiated Milk Protein

    NASA Astrophysics Data System (ADS)

    Fohely, F.; Suardi, N.

    2018-04-01

    The milk has been adopted as a structural nature food for a long era since it is containing most of the growth factors, protective agents, and enzymes needed for the body. a few attempts have been conducted to treat the dairy products especially raw milk by the means of ionizing radiation. as its production has been an expanding industry for many years due to the high demands from the consumers worldwide, there is still some doubt about preserving these products by irradiation. In this work, a preliminary effort to describe the influences of ionizing radiation on raw milk’s protein will be devoted to measuring the spectral absorbance of the total protein (after subjected to varied radiation doses) by UV-VIS-NIR spectroscopy analysis. The absorbance spectrum then analyzed based on absorbance spectra of organic compounds. A comparison is made between the effects of different radiation doses to estimate the influence in milk’s structure.

  19. A dual-band THz absorber based on graphene sheet and ribbons

    NASA Astrophysics Data System (ADS)

    Xing, Rui; Jian, Shuisheng

    2018-03-01

    A dual-band graphene absorber is proposed and investigated in this paper. The absorber consists of the gold substrate, the graphene sheet sandwiched by dielectric layers and the array of graphene ribbon placed on the top. The two absorption peaks of the dual-band are 99.8% at 4.95 THz and 99.6% at 9.2 THz, respectively. Due to the characteristic of tunable surface conductivity of graphene, the absorption can be controlled by adjusting the chemical potential of graphene. We also investigate the dependence of the absorption curve of the proposed absorber on the structure parameters. In addition, the structure of the absorber is very simple and it can be manufactured by chemical vapor deposition (CVD).

  20. Wide band cryogenic ultra-high vacuum microwave absorber

    DOEpatents

    Campisi, I.E.

    1992-05-12

    An absorber waveguide assembly for absorbing higher order modes of microwave energy under cryogenic ultra-high vacuum conditions, that absorbs wide-band multi-mode energy. The absorber is of a special triangular shape, made from flat tiles of silicon carbide and aluminum nitride. The leading sharp end of the absorber is located in a corner of the waveguide and tapers to a larger cross-sectional area whose center is located approximately in the center of the wave guide. The absorber is relatively short, being of less height than the maximum width of the waveguide. 11 figs.

  1. Wide band cryogenic ultra-high vacuum microwave absorber

    DOEpatents

    Campisi, Isidoro E.

    1992-01-01

    An absorber wave guide assembly for absorbing higher order modes of microwave energy under cryogenic ultra-high vacuum conditions, that absorbs wide-band multi-mode energy. The absorber is of a special triangular shape, made from flat tiles of silicon carbide and aluminum nitride. The leading sharp end of the absorber is located in a corner of the wave guide and tapers to a larger cross-sectional area whose center is located approximately in the center of the wave guide. The absorber is relatively short, being of less height than the maximum width of the wave guide.

  2. Two-dimensional QR-coded metamaterial absorber

    NASA Astrophysics Data System (ADS)

    Sui, Sai; Ma, Hua; Wang, Jiafu; Pang, Yongqiang; Zhang, Jieqiu; Qu, Shaobo

    2016-01-01

    In this paper, the design of metamaterial absorbers is proposed based on QR coding and topology optimization. Such absorbers look like QR codes and can be recognized by decoding softwares as well as mobile phones. To verify the design, two lightweight wideband absorbers are designed, which can achieve wideband absorption above 90 % in 6.68-19.30 and 7.00-19.70 GHz, respectively. More importantly, polarization-independent absorption over 90 % can be maintained under incident angle within 55°. The QR code absorber not only can achieve wideband absorption, but also can carry information such as texts and Web sites. They are of important values in applications such identification and electromagnetic protection.

  3. Dendritic-metasurface-based flexible broadband microwave absorbers

    NASA Astrophysics Data System (ADS)

    Wang, Mei; Weng, Bin; Zhao, Jing; Zhao, Xiaopeng

    2017-06-01

    Based on the dendritic metasurface model, a type of flexible and lightweight microwave absorber (MA) comprising resistance film array with dendritic slot (RFADS), dielectric material, and metal plate is proposed. A broadband absorptivity of >80% is obtained both from simulation and experiment at frequency ranges of 3.0-9.2 and 3.2-9.00 GHz, respectively. And the thickness of MA is 5 mm, which is only 0.05λ _{low}, or 0.15λ _ {high}, where the λ _{low} and the λ _{high} are the beginning and the end of the working frequency. By combining this metasurface-based MA with the dendritic-resistance-film-based microwave metasurface absorber (MMA), we designed a broadband MMA. The simulations and experiments showed that this kind of MMA can absorb the radiation effectively at a wide frequency range 4.5-17.5 GHz. And the thickness of this combined MMA is 4 mm. All the structures showed their insensitivity to the incident angle (0°-40°) and the polarization of the incident wave because of their structural symmetry. In addition, the small thickness, low apparent density, and flexibility made those structures possess the advantages of being applied in microwave stealth and radar cross-section (RCS) reduction.

  4. Outcome of bone mineral density in anorexia nervosa patients 11.7 years after first admission.

    PubMed

    Herzog, W; Minne, H; Deter, C; Leidig, G; Schellberg, D; Wüster, C; Gronwald, R; Sarembe, E; Kröger, F; Bergmann, G

    1993-05-01

    Osteopenia is a typical finding in patients suffering from anorexia nervosa. Unfortunately, available longitudinal studies are limited by a relatively short follow-up period. Therefore cross-sectional long-term followup studies may help to determine both the outcome of this bone lesion and variables that influence its subsequent development. Of an initial 66 consecutive patients with anorexia nervosa, 51 (77.3%) could be further evaluated. After an average of 11.7 years following first admission, cross-sectional measurements of lumbar and proximal radial bone mineral density (BMD) were performed. The ability to predict BMD using variables obtained from anamnestic and clinical data was then determined by multiple-regression analysis. The BMD of both radial and lumbar bone in anorexic patients with poor disease outcome (as defined by the Morgan-Russell general outcome categories) deviated by -2.18 and -1.73 SD (Z score), respectively. In patients with a good disease outcome lumbar BMD was significantly less reduced compared with radial BMD (-0.26 versus -0.68 SD). Variables reflecting estrogen deficiency and nutritional status in the course of the disease, that is, relative estrogen exposure (for lumbar BMD) and years of anorexia nervosa (for radial BMD), allowed the best prediction of BMD. A marked reduction in cortical and trabecular BMD in anorexic patients with poor disease outcome suggests a higher risk of fractures in these patients. Furthermore, the finding of a persistently reduced cortical and a slightly reduced trabecular BMD, even in patients with good disease outcome, suggests that a recovery of trabecular BMD might be possible, at least in part. Recovery of cortical bone, if possible at all, seems to proceed more slowly.

  5. Long‐term effect of head trauma on intellectual abilities: a 16‐year outcome study

    PubMed Central

    Wood, R Ll; Rutterford, N A

    2006-01-01

    Background Intelligence was assessed in a group of 74 people with head injury, 16 years after injury (mean 16.77 years; range 10–32 years), and compared with their performance when assessed at an early stage in recovery (mean 1.05 years). Aims To confirm the presence of long‐term impairment relative to estimates of pre‐accident ability, to confirm signs of deterioration between early (T1) and late (T2) measures, and to examine relationships between severity of injury, time since injury, length of education, sex and age, and performance on intelligence tests at T2. Expected outcomes On the basis of evidence from other studies, a significant difference was expected between estimates of pre‐accident intelligence and abilities measured at T1 and T2. Deterioration in performance between T1 and T2, and relationships between demographic variables, severity of injury and intellectual performance were also expected. Results and conclusion The data supported long‐term intellectual impairment, but there was no deterioration in abilities between T1 and T2. Performance on intelligence tests was associated with years of education but not with other factors. PMID:16772355

  6. EUV multilayer defect compensation (MDC) by absorber pattern modification: from theory to wafer validation

    NASA Astrophysics Data System (ADS)

    Pang, Linyong; Hu, Peter; Satake, Masaki; Tolani, Vikram; Peng, Danping; Li, Ying; Chen, Dongxue

    2011-11-01

    According to the ITRS roadmap, mask defects are among the top technical challenges to introduce extreme ultraviolet (EUV) lithography into production. Making a multilayer defect-free extreme ultraviolet (EUV) blank is not possible today, and is unlikely to happen in the next few years. This means that EUV must work with multilayer defects present on the mask. The method proposed by Luminescent is to compensate effects of multilayer defects on images by modifying the absorber patterns. The effect of a multilayer defect is to distort the images of adjacent absorber patterns. Although the defect cannot be repaired, the images may be restored to their desired targets by changing the absorber patterns. This method was first introduced in our paper at BACUS 2010, which described a simple pixel-based compensation algorithm using a fast multilayer model. The fast model made it possible to complete the compensation calculations in seconds, instead of days or weeks required for rigorous Finite Domain Time Difference (FDTD) simulations. Our SPIE 2011 paper introduced an advanced compensation algorithm using the Level Set Method for 2D absorber patterns. In this paper the method is extended to consider process window, and allow repair tool constraints, such as permitting etching but not deposition. The multilayer defect growth model is also enhanced so that the multilayer defect can be "inverted", or recovered from the top layer profile using a calibrated model.

  7. Multiligament Knee Injuries in Older Adolescents: A 2-Year Minimum Follow-up Study

    PubMed Central

    Godin, Jonathan A.; Cinque, Mark E.; Pogorzelski, Jonas; Moatshe, Gilbert; Chahla, Jorge; LaPrade, Robert F.

    2017-01-01

    Background: Multiligament knee injuries cause significant functional impairment. Adults undergoing anatomic reconstruction of multiligament knee injuries have excellent outcomes postoperatively. However, less is known about the outcomes in adolescent patients following multiligament reconstruction. Purpose/Hypothesis: We aimed to assess patient outcomes and failure rates following unstaged multiligament reconstruction in an adolescent population at a minimum 2-year follow-up. We hypothesized that outcomes of multiligament reconstruction in these patients would be comparable to previously reported outcomes in the adult population. Study Design: Case series; Level of evidence, 4. Methods: The study included patients who had undergone multiligament knee reconstruction at 19 years of age or younger and had at least 2 years of follow-up. All procedures were performed by the same surgeon. Exclusion criteria included patient age 14 years or younger at the time of surgery, open physes, prior ipsilateral meniscal or knee ligament surgery, or a tibial plateau fracture at the time of injury. Multiligament reconstruction was defined as a reconstruction of at least 1 cruciate ligament and at least 1 component of the posterolateral corner or the medial knee. Patients were evaluated according to Lysholm score, Tegner score, Short Form–12 physical component summary (SF-12 PCS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, and postoperative patient satisfaction. Results: Twenty patients (mean age, 17.7 years; mean follow-up, 37.1 months) were included in this study. No patient required additional ligament surgery after the index surgery because of graft failure. The median preoperative Lysholm score was 49.5 (range, 18-90), and the median postoperative Lysholm score was 86 (range, 44-100) (P < .001). The median preoperative Tegner activity score was 2 (range, 0-9), and the median postoperative Tegner activity score was 6 (range, 2-10) (P = .012

  8. Two-year outcome after early or late Intervention in non-ST elevation acute coronary syndrome

    PubMed Central

    Badings, Erik A; Remkes, Wouter S; The, Salem H K; Dambrink, Jan-Henk E; Tjeerdsma, Geert; Rasoul, Saman; Timmer, Jorik R; van der Wielen, Marloes L J; Lok, Dirk J A; Hermanides, Renicus S; Van Wijngaarden, Jan; Suryapranata, Harry; van ’t Hof, Arnoud W J

    2017-01-01

    Objective To compare long-term outcome of an early to a delayed invasive strategy in high-risk patients with non-ST elevation acute coronary syndrome (NSTE-ACS). Methods This prospective, multicentre trial included patients with NSTE-ACS and at least two out of three of the following high-risk criteria: (1) evidence of extensive myocardial ischaemia on ECG, (2) elevated biomarkers for myocardial necrosis and (3) age above 65 years. Patients were randomised to either an early (angiography and revascularisation if appropriate <12 hours) or a delayed invasive strategy (>48 hours after randomisation). Endpoint for this prespecified long-term follow-up was the composite incidence of death or reinfarction after 2 years. Data collection was performed by telephone contact with the patients, their relatives or general practitioner and by review of hospital records. Results Endpoint status after 2-year follow-up was collected in 521 of 542 initially enrolled patients. Incidence of death or reinfarction was 11.8% in the early and 13.1% in the delayed treatment group (relative risk (RR)=0.90, 95% CI 0.57 to 1.42). No significant differences were found in occurrence of the individual components of the primary endpoint: death 6.1% vs 8.9%, RR 0.69 (95% CI 0.37 to 1.27), reinfarction 6.5% vs 5.4%, RR 1.20 (95% CI 0.60 to 2.38). Post-hoc subgroup analysis showed statistical significant interaction between age and treatment strategy on outcome (p=0.02). Conclusions After 2 years follow-up, no difference in incidence of death or reinfarction was seen between early to late invasive strategy. These findings are in line with results of other studies with longer follow-up. Older patients seem to benefit more from early invasive treatment. PMID:28409008

  9. Measurements of light absorbing particulates on the glaciers in the Cordillera Blanca, Peru

    NASA Astrophysics Data System (ADS)

    Schmitt, C. G.; All, J. D.; Schwarz, J. P.; Arnott, W. P.; Cole, R. J.; Lapham, E.; Celestian, A.

    2014-10-01

    Glaciers in the tropical Andes have been rapidly losing mass since the 1970s. In addition to the documented increase in air temperature, increases in light absorbing particulates deposited on glaciers could be contributing to the observed glacier loss. Here we report on measurements of light absorbing particulates sampled from glaciers during three surveys in the Cordillera Blanca in Peru. During three research expeditions in the dry seasons (May-August) of 2011, 2012 and 2013, two hundred and forty snow samples were collected from fifteen mountain peaks over altitudes ranging from 4800 to nearly 6800 m. Several mountains were sampled each of the three expeditions and some mountains were sampled multiple times during the same expedition. Collected snow samples were melted and filtered in the field then later analyzed using the Light Absorption Heating Method (LAHM), a new technique that measures the ability of particulates on filters to absorb visible light. LAHM results have been calibrated using filters with known amounts of fullerene soot, a common industrial surrogate for black carbon (BC). As sample filters often contain dust in addition to BC, results are presented in terms of effective Black Carbon (eBC). During the 2013 survey, snow samples were collected and kept frozen for analysis with a Single Particle Soot Photometer (SP2). Calculated eBC mass from the filter analysis and the SP2 refractory Black Carbon (rBC) results were well correlated (r2 = 0.92). These results indicate that a substantial portion of the light absorbing particulates in the more polluted areas were likely BC. The three years of data show that glaciers in the Cordillera Blanca Mountains close to human population centers have substantially higher levels of eBC (as high as 70 ng g-1) than remote glaciers (as low as 2.0 ng g-1 eBC), indicating that population centers can influence local glaciers by sourcing BC.

  10. Generation of dark solitons in erbium-doped fiber lasers based Sb(2)Te(3) saturable absorbers.

    PubMed

    Liu, Wenjun; Pang, Lihui; Han, Hainian; Tian, Wenlong; Chen, Hao; Lei, Ming; Yan, Peiguang; Wei, Zhiyi

    2015-10-05

    Dark solitons, which have better stability in the presence of noise, have potential applications in optical communication and ultrafast optics. In this paper, the dark soliton formation in erbium-doped fiber lasers based Sb(2)Te(3) saturable absorber (SA) is first experimentally demonstrated. The Sb(2)Te(3) SA is fabricated by using the pulsed laser deposition method. The generated dark solitons are centered at the wavelength of 1530 nm and repetition rate of 94 MHz. Analytic solutions for dark solitons are also obtained theoretically.

  11. On the definition of absorbed dose

    NASA Astrophysics Data System (ADS)

    Grusell, Erik

    2015-02-01

    Purpose: The quantity absorbed dose is used extensively in all areas concerning the interaction of ionizing radiation with biological organisms, as well as with matter in general. The most recent and authoritative definition of absorbed dose is given by the International Commission on Radiation Units and Measurements (ICRU) in ICRU Report 85. However, that definition is incomplete. The purpose of the present work is to give a rigorous definition of absorbed dose. Methods: Absorbed dose is defined in terms of the random variable specific energy imparted. A random variable is a mathematical function, and it cannot be defined without specifying its domain of definition which is a probability space. This is not done in report 85 by the ICRU, mentioned above. Results: In the present work a definition of a suitable probability space is given, so that a rigorous definition of absorbed dose is possible. This necessarily includes the specification of the experiment which the probability space describes. In this case this is an irradiation, which is specified by the initial particles released and by the material objects which can interact with the radiation. Some consequences are discussed. Specific energy imparted is defined for a volume, and the definition of absorbed dose as a point function involves the specific energy imparted for a small mass contained in a volume surrounding the point. A possible more precise definition of this volume is suggested and discussed. Conclusions: The importance of absorbed dose motivates a proper definition, and one is given in the present work. No rigorous definition has been presented before.

  12. [Can epidemiological factors affect the 2-year outcomes after surgery for degenerative lumbar disease in terms of quality of life, disability and post-surgical pain?].

    PubMed

    Lozano-Álvarez, C; Pérez-Prieto, D; Saló-Bru, G; Molina, A; Lladó, A; Cáceres, E; Ramírez, M

    2014-01-01

    To evaluate the influence of epidemiological factors on the outcomes of surgery for degenerative lumbar disease in terms of quality of life, disability and chronic pain. A total of 263 patients who received surgery for degenerative lumbar disease (2005-2008) were included in the study. The epidemiological data collected were age, gender, employment status, and co-morbidity. The SF-36, Oswestry Disability Index (ODI), Core Outcomes Measures Index (COMI), and VAS score for lumbar and sciatic pain were measure before and 2 years after surgery. The correlation between epidemiological data and questionnaire results, as well as any independent prognostic factors, were assessed in the data analysis. The mean age of the patients was 54.0 years (22-86), and 131 were female (49.8%). There were 42 (16%) lost to follow-up. Statistically significant correlations (P<.05) were observed between age, gender, co-morbidity, permanent sick leave, and pre-operative pain with changes in the ODI, COMI, physical and SF-36 mental scales, and lumbar and sciatic VAS. Linear regression analysis showed permanent sick leave and age as predictive factors of disability (β=14.146; 95% CI: 9.09 - 29.58; P<.01 and β=0.334; 95% CI: 0.40 - 0.98, P<.05, respectively), and change in quality of life (β=-8.568; 95% CI: -14.88 - -2.26; p<.01 and β=-0.228, IC 95% CI: -0.40 - -0.06, P<.05, respectively). Based on our findings, age and permanent sick leave have to be considered as negative epidemiologic predictive factors of the outcome of degenerative lumbar disease surgery. Copyright © 2012 SECOT. Published by Elsevier Espana. All rights reserved.

  13. Family Structure, Family Stability, and Outcomes of Five-Year-Old Children

    PubMed Central

    Brooks-Gunn, Jeanne; Waldfogel, Jane

    2013-01-01

    This study exploits data from the Fragile Families and Child Wellbeing Study, a birth cohort study of a diverse sample of children from twenty U.S. cities (N = 3,676), to examine how cognitive, behavioural, and health outcomes of five-year old children differ according to their family structure and family stability. We define three models: one that measures family structure at birth only, a second that measures current family structure at year five conditional on family structure at birth, and a third that measures changes in family structure from birth to age five. We find that while family structure has persistent links to child outcomes, the effects are significantly altered by stability of the family structure over time. These findings remain robust even after addressing selection. PMID:24163735

  14. [Internal fixation treatment of multiple rib fractures with absorbable rib-connecting-pins].

    PubMed

    Liu, Jinliang; Li, Keyao; He, Jianning

    2011-01-01

    To study the indications, methods, and therapeutic effect of absorbable rib-connecting-pins fixation in the treatment of multiple rib fractures. Between March 2007 and September 2009, 40 patients with multiple rib fractures received internal fixation with absorbable rib-connecting-pins, including 8 one-side flail chest and 1 two-side flail chest. There were 32 males and 8 females with an average age of 39.8 years (range, 25-72 years). The injury was caused by traffic accident in 32 cases, falling from height in 6 cases, and blunt hitting in 2 cases. Preoperatively, imaging data of the chest X-ray or spiral CT three-dimensional (3D) examination showed that all patients had multiple ribs fractures and displacement. The number of fractured ribs was 4-10 (median, 6), and the fracture location ranged from the 2nd to the 10th ribs. Of them, 28 cases were accompanied by hemathorax, pneumothorax or hemopneumothorax; 5 cases by thoracic organ injury; and 10 cases by other part trauma. The time from injury to hospitalization was less than 1 day in 26 cases, 1-3 days in 12 cases, and 3-6 days in 2 cases, and the time from hospitalization to operation was 3 hours to 3 days (mean, 1.2 days). The median fixation rib number was 5 (range, 3-8). The mean operative time, the time in bed, and hospitalization days were 32 minutes (range, 15-50 minutes), 4.5 days (range, 2-7 days), and 11.2 days (range, 5-18 days), respectively. All incisions healed by first intention. No pulmonary infection, pulmonary atelectasis, intrathoracic infection or other complications occurred. All cases were followed up 6-12 months (mean, 8 months). PaO2 [(86.6 +/- 2.2) mmHg (1 mm Hg = 0.133 kPa)] and SpO2 (97.2% +/- 0.6%) at 2 hours after operation were obviously improved when compared with preoperative ones (PaO2 (53.6 + 4.7) mm Hg and SpO2 (86.2% + 1.8%)], showing significant differences (t = 2.971, P = 0.005; t = 2.426, P = 0.020). The chest X-ray films or spiral CT 3D indicated that fracture of rib

  15. Maximum dose rate is a determinant of hypothyroidism after 131I therapy of Graves' disease but the total thyroid absorbed dose is not.

    PubMed

    Krohn, Thomas; Hänscheid, Heribert; Müller, Berthold; Behrendt, Florian F; Heinzel, Alexander; Mottaghy, Felix M; Verburg, Frederik A

    2014-11-01

    The determinants of successful (131)I therapy of Graves' disease (GD) are unclear. To relate dosimetry parameters to outcome of therapy to identify significant determinants eu- and/or hypothyroidism after (131)I therapy in patients with GD. A retrospective study in which 206 Patients with GD treated in University Hospital between November 1999 and January 2011. All received (131)I therapy aiming at a total absorbed dose to the thyroid of 250 Gy based on pre-therapeutic dosimetry. Post-therapy dosimetric thyroid measurements were performed twice daily until discharge. From these measurements, thyroid (131)I half-life, the total thyroid absorbed dose, and the maximum dose rate after (131)I administration were calculated. In all, 48.5% of patients were hypothyroid and 28.6% of patients were euthyroid after (131)I therapy. In univariate analysis, nonhyperthyroid and hyperthyroid patients only differed by sex. A lower thyroid mass, a higher activity per gram thyroid tissue, a shorter effective thyroidal (131)I half-life, and a higher maximum dose rate, but not the total thyroid absorbed dose, were significantly associated with hypothyroidism. In multivariate analysis, the maximum dose rate remained the only significant determinant of hypothyroidism (P < .001). Maximum dose rates of 2.2 Gy/h and higher were associated with a 100% hypothyroidism rate. Not the total thyroid absorbed dose, but the maximum dose rate is a determinant of successfully achieving hypothyroidism in Graves' disease. Dosimetric concepts aiming at a specific total thyroid absorbed dose will therefore require reconsideration if our data are confirmed prospectively.

  16. Passive Q-switching of ˜2.7 µm Er:Lu2O3 ceramic laser with a semiconductor saturable absorber mirror

    NASA Astrophysics Data System (ADS)

    Ren, Xiaojing; Shen, Deyuan; Zhang, Jian; Tang, Dingyuan

    2018-02-01

    We demonstrate the passively Q-switched operation of an Er:Lu2O3 ceramic laser at ˜2.7 µm for the first time, to the best of our knowledge. By using a semiconductor saturable absorber mirror (SESAM), stable pulse trains with a repetition rate of 20-33.3 kHz are produced in a compacted v-shaped resonator. The pulse duration (FWHM), pulse energy, and peak power are 660 ns, 1.8 µJ, and ˜2.73 W, respectively, at 33.3 kHz repetition rate. Prospects for further improvements in terms of laser performances are discussed.

  17. Magnetic field effects on microwave absorbing materials

    NASA Technical Reports Server (NTRS)

    Goldberg, Ira; Hollingsworth, Charles S.; Mckinney, Ted M.

    1991-01-01

    The objective of this program was to gather information to formulate a microwave absorber that can work in the presence of strong constant direct current (DC) magnetic fields. The program was conducted in four steps. The first step was to investigate the electrical and magnetic properties of magnetic and ferrite microwave absorbers in the presence of strong magnetic fields. This included both experimental measurements and a literature survey of properties that may be applicable to finding an appropriate absorbing material. The second step was to identify those material properties that will produce desirable absorptive properties in the presence of intense magnetic fields and determine the range of magnetic field in which the absorbers remain effective. The third step was to establish ferrite absorber designs that will produce low reflection and adequate absorption in the presence of intense inhomogeneous static magnetic fields. The fourth and final step was to prepare and test samples of such magnetic microwave absorbers if such designs seem practical.

  18. Additive manufacturing of RF absorbers

    NASA Astrophysics Data System (ADS)

    Mills, Matthew S.

    The ability of additive manufacturing techniques to fabricate integrated electromagnetic absorbers tuned for specific radio frequency bands within structural composites allows for unique combinations of mechanical and electromagnetic properties. These composites and films can be used for RF shielding of sensitive electromagnetic components through in-plane and out-of-plane RF absorption. Structural composites are a common building block of many commercial platforms. These platforms may be placed in situations in which there is a need for embedded RF absorbing properties along with structural properties. Instead of adding radar absorbing treatments to the external surface of existing structures, which adds increased size, weight and cost; it could prove to be advantageous to integrate the microwave absorbing properties directly into the composite during the fabrication process. In this thesis, a method based on additive manufacturing techniques of composites structures with prescribed electromagnetic loss, within the frequency range 1 to 26GHz, is presented. This method utilizes screen printing and nScrypt micro dispensing to pattern a carbon based ink onto low loss substrates. The materials chosen for this study will be presented, and the fabrication technique that these materials went through to create RF absorbing structures will be described. The calibration methods used, the modeling of the RF structures, and the applications in which this technology can be utilized will also be presented.

  19. The Ahmed Versus Baerveldt Study: Five-Year Treatment Outcomes.

    PubMed

    Christakis, Panos G; Kalenak, Jeffrey W; Tsai, James C; Zurakowski, David; Kammer, Jeffrey A; Harasymowycz, Paul J; Mura, Juan J; Cantor, Louis B; Ahmed, Iqbal I K

    2016-10-01

    To compare 2 frequently used aqueous shunts for the treatment of glaucoma. International, multicenter, randomized trial. Patients aged 18 years or older with uncontrolled glaucoma despite maximum tolerated medical therapy, many of whom had failed or were at high risk of failing trabeculectomy. Eligible patients were randomized to receive an Ahmed-FP7 valve implant (New World Medical, Inc, Rancho Cucamonga, CA) or a Baerveldt-350 implant (Abbott Medical Optics, Inc, Santa Ana, CA) using a standardized surgical technique. The primary outcome was failure, defined as intraocular pressure (IOP) outside the target range (5-18 mmHg) or reduced <20% from baseline for 2 consecutive visits after 3 months, severe vision loss, or de novo glaucoma surgery. Secondary outcomes measures included IOP, medication use, visual acuity, complications, and interventions. A total of 238 patients were randomized; 124 received the Ahmed-FP7 implant, and 114 received the Baerveldt-350 implant. Baseline characteristics were similar between groups. Mean preoperative IOP was 31.4±10.8 mmHg on 3.1±1.0 glaucoma medications. At 5 years, the cumulative failure rate was 53% in the Ahmed group and 40% in the Baerveldt group (P = 0.04). The main reason for failure in both groups was high IOP, and the cumulative de novo glaucoma reoperation rate was 18% in the Ahmed group and 11% in the Baerveldt group (P = 0.22). Hypotony resulted in failure in 5 patients (4%) in the Baerveldt group compared with none in the Ahmed group (P = 0.02). Mean IOP was 16.6±5.9 mmHg in the Ahmed group (47% reduction) and 13.6±5.0 mmHg in the Baerveldt group (57% reduction, P = 0.001). Mean medication use was 1.8±1.5 mmHg in the Ahmed group (44% reduction) and 1.2±1.3 mmHg in the Baerveldt group (61% reduction, P = 0.03). The 2 groups had similar complication rates (Ahmed 63%, Baerveldt 69%) and intervention rates (Ahmed 41%, Baerveldt 41%). Most complications were transient, and most interventions were slit

  20. Warm Absorber Diagnostics of AGN Dynamics

    NASA Astrophysics Data System (ADS)

    Kallman, Timothy

    Warm absorbers and related phenomena are observable manifestations of outflows or winds from active galactic nuclei (AGN) that have great potential value. Understanding AGN outflows is important for explaining the mass budgets of the central accreting black hole, and also for understanding feedback and the apparent co-evolution of black holes and their host galaxies. In the X-ray band warm absorbers are observed as photoelectric absorption and resonance line scattering features in the 0.5-10 keV energy band; the UV band also shows resonance line absorption. Warm absorbers are common in low luminosity AGN and they have been extensively studied observationally. They may play an important role in AGN feedback, regulating the net accretion onto the black hole and providing mechanical energy to the surroundings. However, fundamental properties of the warm absorbers are not known: What is the mechanism which drives the outflow?; what is the gas density in the flow and the geometrical distribution of the outflow?; what is the explanation for the apparent relation between warm absorbers and the surprising quasi-relativistic 'ultrafast outflows' (UFOs)? We propose a focused set of model calculations that are aimed at synthesizing observable properties of warm absorber flows and associated quantities. These will be used to explore various scenarios for warm absorber dynamics in order to answer the questions in the previous paragraph. The guiding principle will be to examine as wide a range as possible of warm absorber driving mechanisms, geometry and other properties, but with as careful consideration as possible to physical consistency. We will build on our previous work, which was a systematic campaign for testing important class of scenarios for driving the outflows. We have developed a set of tools that are unique and well suited for dynamical calculations including radiation in this context. We also have state-of-the-art tools for generating synthetic spectra, which are

  1. UV-visible absorbance spectroscopy as a proxy for peatland dissolved organic carbon (DOC) quantity and quality: considerations on wavelength and absorbance degradation.

    PubMed

    Peacock, Mike; Evans, Chris D; Fenner, Nathalie; Freeman, Chris; Gough, Rachel; Jones, Timothy G; Lebron, Inma

    2014-05-01

    Absorbance in the UV or visible spectrum (UV-vis) is commonly used as a proxy for DOC concentrations in waters draining upland catchments. To determine the appropriateness of different UV-vis measurements we used surface and pore water samples from two Welsh peatlands in four different experiments: (i) an assessment of single wavelength proxies (1 nm increments between 230-800 nm) for DOC concentration demonstrated that 254 nm was more accurate than 400 nm. The highest R(2) values between absorbance and DOC concentration were generated using 263 nm for one sample set (R(2) = 0.91), and 230 nm for the other three sample sets (respective R(2) values of 0.86, 0.81, and 0.93). (ii) A comparison of different DOC concentration proxies, including single wavelength proxies, a two wavelength model, a proxy using phenolic concentration, and a proxy using the area under a UV spectrum at 250-350 nm. It was found that both a single wavelength proxy (≤263 nm) and a two wavelength model performed well for both pore water and surface water. (iii) An evaluation of the E2 : E3, E2 : E4, E4 : E6 ratios, and SUVA (absorbance at 254 nm normalised to DOC concentration) as indicators of DOC quality showed that the E4 : E6 ratio was subject to extensive variation over time, and was highly correlated between surface water and pore water, suggesting that it is a useful metric to determine temporal changes in DOC quality. (iv) A repeated weekly analysis over twelve weeks showed no consistent change in UV-vis absorbance, and therefore an inferred lack of degradation of total DOC in samples that were filtered and stored in the dark at 4 °C.

  2. Muon Intensity Increase by Wedge Absorbers for Low-E Muon Experiments

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Neuffer, D. V.; Stratakis, D.; Bradley, J.

    2017-09-01

    Low energy muon experiments such as mu2e and g-2 have a limited energy spread acceptance. Following techniques developed in muon cooling studies and the MICE experiment, the number of muons within the desired energy spread can be increased by the matched use of wedge absorbers. More generally, the phase space of muon beams can be manipulated by absorbers in beam transport lines. Applications with simulation results are presented.

  3. 21 CFR 868.5300 - Carbon dioxide absorbent.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Carbon dioxide absorbent. 868.5300 Section 868...) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5300 Carbon dioxide absorbent. (a) Identification. A carbon dioxide absorbent is a device intended for medical purposes that consists of an...

  4. 21 CFR 868.5300 - Carbon dioxide absorbent.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Carbon dioxide absorbent. 868.5300 Section 868...) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5300 Carbon dioxide absorbent. (a) Identification. A carbon dioxide absorbent is a device intended for medical purposes that consists of an...

  5. 21 CFR 868.5300 - Carbon dioxide absorbent.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Carbon dioxide absorbent. 868.5300 Section 868...) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5300 Carbon dioxide absorbent. (a) Identification. A carbon dioxide absorbent is a device intended for medical purposes that consists of an...

  6. [Absorbed doses to critical organs from full mouth dental radiography].

    PubMed

    Zhang, G; Yasuhiko, O; Hidegiko, Y

    1999-01-01

    A few studies were reported in China on radiological risk of dental radiography. The aim of this study is to evaluate the absorbed doses of patients from the full mouth radiographs, and to find out the contribution from each projection to the total absorbed dose of the organs. Absorbed doses to critical organs were measured from 14-film complete dental radiography. The organs included pituitary, optical lens, parotid glands, submandibular glands, sublingual glands, thyroid, breasts, ovary, testes and the skin in center field of each projection were studied. A-radiation analog dosimetry system (RANDO) phantom with thermoluminescent dosimeters (ILD200) was used for the study. All of the exposure parameters were fixed. The total filtration was 2 mm Al equivalent. The column collaboration was 6 cm in diameter and 20 cm in length. The absorbed doses of organs were measured three times in each projection of the full-mouth series (FMS) exposures. The absorbed dose of lenses in FMS (249 microGy) in present study was much less (10%) than the doses (2,630 microGy) reported in 1976. The doses absorbed of other organs in the present study were thyroid gland (125 microGy), pituitary gland (112 microGy), parotid gland (153 microGy), submandibular gland (629 microGy), sublingual gland (1,900 microGy), and breast gland (12 microGy). The doses of the ovary and testis were to small to further analysis. All of the results show that the radiation risk to patients in intraoral radiograph has been reduced significantly. In the pituitary, half of the dose is from both sides of the maxillary molar projection. For the lenses, the largest contribultions of radiation (60%) come from the ipsilateral molar and premolar projection of maxilla. In parotid gland, up to 57% of the dose is from the contralateral molar, pre-molar and canine of maxilla. It could be derived that about 90% of the absorbed doses could be avoided in FMS if the column collimator is 20 cm long and the filter is 2.0 mm thick

  7. Frequency Tuning of Vibration Absorber Using Topology Optimization

    NASA Astrophysics Data System (ADS)

    Harel, Swapnil Subhash

    A tuned mass absorber is a system for reducing the amplitude in one oscillator by coupling it to a second oscillator. If tuned correctly, the maximum amplitude of the first oscillator in response to a periodic driver will be lowered, and much of the vibration will be 'transferred' to the second oscillator. The tuned vibration absorber (TVA) has been utilized for vibration control purposes in many sectors of Civil/Automotive/Aerospace Engineering for many decades since its inception. Time and again we come across a situation in which a vibratory system is required to run near resonance. In the past, approaches have been made to design such auxiliary spring mass tuned absorbers for the safety of the structures. This research focuses on the development and optimization of continuously tuned mass absorbers as a substitute to the discretely tuned mass absorbers (spring- mass system). After conducting the study of structural behavior, the boundary condition and frequency to which the absorber is to be tuned are determined. The Modal analysis approach is used to determine mode shapes and frequencies. The absorber is designed and optimized using the topology optimization tool, which simultaneously designs, optimizes and tunes the absorber to the desired frequency. The tuned, optimized absorber, after post processing, is attached to the target structure. The number of the absorbers are increased to amplify bandwidth and thereby upgrade the safety of structure for a wide range of frequency. The frequency response analysis is carried out using various combinations of structure and number of absorber cell.

  8. A SPECTROPOLARIMETRIC TEST OF THE STRUCTURE OF THE INTRINSIC ABSORBERS IN THE QUASAR HS 1603+3820

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Misawa, Toru; Kawabata, Koji S.; Eracleous, Michael

    We report the results of a spectropolarimetric observation of the C VI 'mini-broad' absorption line (mini-BAL) in the quasar HS 1603+3820 (z {sub em} = 2.542). The observations were carried out with the FOCAS instrument on the Subaru Telescope and yielded an extremely high polarization sensitivity of {delta}p{approx} 0.1%, at a resolving power of R {approx} 1500. HS 1603+3820 has been the target of a high-resolution spectroscopic monitoring campaign for more than four years, aimed at studying its highly variable C VI mini-BAL profile. Using the monitoring observations in an earlier paper, we were able to narrow down the causesmore » of the variability to the following two scenarios: (1) scattering material of variable optical depth redirecting photons around the absorber and (2) a variable, highly ionized screen between the continuum source and the absorber which modulates the UV continuum incident on the absorber. The observations presented here provide a crucial test of the scattering scenario and lead us to disfavor it because (1) the polarization level is very small (p {approx} 0.6%) throughout the spectrum and (2) the polarization level does not increase across the mini-BAL trough. Thus, the variable screen scenario emerges as our favored explanation of the C VI mini-BAL variability. Our conclusion is bolstered by recent X-ray observations of nearby mini-BAL quasars, which show a rapidly variable soft X-ray continuum that appears to be the result of transmission through an ionized absorber of variable ionization parameter and optical depth.« less

  9. X-ray Absorbers as Probes of AGN Unification

    NASA Astrophysics Data System (ADS)

    Kazannas, Demosthenes

    We have developed, over the past few years, models of photoionized MHD winds off black hole accretion disks and showed that their properties are consistent with those of the AGN warm absorbers and those of the tori invoked in AGN unification schemes. Furthermore, we have shown that these models are sufficiently robust to reproduce the absorber properties (UV and X-ray) in AGN classes as diverse as Seyferts and BAL QSOs.With this proposal we request funding to model archival spectroscopic data of eighteen AGN with photoionized MHD winds. Successful implementation of this program will provide for the first time an association of the properties of warm absorbers with the parameters of a well-defined physical model, namely their density profiles, mass fluxes and inclination angles. Furthermore, determination of these parameters for our AGN sample will allow a statistical analysis of their properties and, as such, a better understanding of the properties of AGN structure. The value of our models lies in their simplicity: the winds are essentially analytic with only a small number of parameters. This simplicity makes possible the generation of a large grid of models which will be made available to the community through XSPEC/mtable for analysis of similar data by the observers.

  10. Tuning Transpiration by Interfacial Solar Absorber-Leaf Engineering.

    PubMed

    Zhuang, Shendong; Zhou, Lin; Xu, Weichao; Xu, Ning; Hu, Xiaozhen; Li, Xiuqiang; Lv, Guangxin; Zheng, Qinghui; Zhu, Shining; Wang, Zhenlin; Zhu, Jia

    2018-02-01

    Plant transpiration, a process of water movement through a plant and its evaporation from aerial parts especially leaves, consumes a large component of the total continental precipitation (≈48%) and significantly influences global water distribution and climate. To date, various chemical and/or biological explorations have been made to tune the transpiration but with uncertain environmental risks. In recent years, interfacial solar steam/vapor generation is attracting a lot of attention for achieving high energy transfer efficiency. Various optical and thermal designs at the solar absorber-water interface for potential applications in water purification, seawater desalination, and power generation appear. In this work, the concept of interfacial solar vapor generation is extended to tunable plant transpiration by showing for the first time that the transpiration efficiency can also be enhanced or suppressed through engineering the solar absorber-leaf interface. By tuning the solar absorption of membrane in direct touch with green leaf, surface temperature of green leaf will change accordingly because of photothermal effect, thus the transpiration efficiency as well as temperature and relative humidity in the surrounding environment will be tuned. This tunable transpiration by interfacial absorber-leaf engineering can open an alternative avenue to regulate local atmospheric temperature, humidity, and eventually hydrologic cycle.

  11. Reflection by absorbing periodically stratified media

    NASA Astrophysics Data System (ADS)

    Lekner, John

    2014-03-01

    Existing theory gives the optical properties of a periodically stratified medium in terms of a two by two matrix. This theory is valid also for absorbing media, because the matrix remains unimodular. The main effect of absorption is that the reflection (of either polarization) becomes independent of the number of periods N, and of the substrate properties, provided N exceeds a certain value which depends on the absorption. The s and p reflections are then given by simple formulae. The stop-band structure, which gives total reflection in bands of frequency and angle of incidence in the non-absorbing case, remains influential in weakly absorbing media, causing strong variations in reflectivity. The theory is applied to the frequency dependence of the normal-incidence reflectivity of a quarter-wave stack in which the high-index and low-index layers both absorb weakly. Analytical expressions are obtained for the frequency at which the reflectivity is maximum, the maximum reflectivity, and also for the reflectivity at the band edges of the stop band of the non-absorbing stack.

  12. 21 CFR 880.5300 - Medical absorbent fiber.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Medical absorbent fiber. 880.5300 Section 880.5300...) MEDICAL DEVICES GENERAL HOSPITAL AND PERSONAL USE DEVICES General Hospital and Personal Use Therapeutic Devices § 880.5300 Medical absorbent fiber. (a) Identification. A medical absorbent fiber is a device...

  13. 21 CFR 880.5300 - Medical absorbent fiber.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Medical absorbent fiber. 880.5300 Section 880.5300...) MEDICAL DEVICES GENERAL HOSPITAL AND PERSONAL USE DEVICES General Hospital and Personal Use Therapeutic Devices § 880.5300 Medical absorbent fiber. (a) Identification. A medical absorbent fiber is a device...

  14. Au nanocage/SiO2 saturable absorber for passive Q-switching Yb-doped fiber laser

    NASA Astrophysics Data System (ADS)

    Bai, Jinxi; Li, Ping; Guo, Lei; Zhang, Baitao; Hu, Qiongyu; Wang, Lili; Liu, Binghai; Chen, Xiaohan

    2018-05-01

    Au nanocages/SiO2 (Au-NCs/SiO2) with the surface plasmon resonance peak at 1060 nm were fabricated and experimentally exploited as the saturable absorber in an all-fiber passively Q-switched ytterbium-doped fiber laser for the first time. Under a pump power of 440 mW, the average output power of 10.6 mW was obtained with the pulse duration 1.4 µs and the repetition rate of 126.9 kHz at 1060.5 nm with the 3 dB spectral width of 0.131 nm. The results indicate that Au-NCs/SiO2 exhibits the potential for applications in the field of pulse lasers.

  15. Mitral balloon valvuloplasty during pregnancy:The long term up to 17 years obstetric outcome and childhood development

    PubMed Central

    A, Gulraze; W, Kurdi; FA, Niaz; ME, Fawzy

    2014-01-01

    Background & Objectives : We report 17 years outcome of subsequent pregnancies of women with severe Mitral Stenosis (MS) who underwent Mitral Balloon Valvuloplasty (MBV) during pregnancy and the follow up of the children born of such pregnancies. Methods: Twenty three pregnant patients suffering from severe MS (NYHA-New York Heart Association class III/IV) who underwent MBV by Inoue balloon catheter technique during second trimester were enrolled. The study was performed between January 1992 and December 2008 at King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia, during which time, details about the obstetric outcome and childhood development were recorded. Mean follow up period was 10± 5.5 years (range 1-17 years). Results: MBV was successful in all patients with improvement in their NYHA class to I/II. All patients were followed until term and had uneventful course after MBV. Twenty two (95.6%) patients delivered 23 babies including a twin birth. These children exhibited normal growth and development according to their age. Nineteen patients had further pregnancies and gave birth to 38 live & healthy babies with one still birth and no unfavorable maternal outcome. Of these, 97.4% were singleton pregnancies while 2.6% were twin pregnancies. Spontaneous abortions were recorded in 21.5% and there was one still birth (2.5%) and one ectopic pregnancy (2.5%). Conclusion : Mitral Balloon Valvuloplasty is a safe and useful procedure during pregnancy, with no short or long term adverse affects on the mothers and their obstetric future. The children born of subsequent pregnancies exhibited normal physical and mental development. PMID:24639837

  16. De novo status epilepticus is associated with adverse outcome: An 11-year retrospective study in Hong Kong.

    PubMed

    Lui, Hoi Ki Kate; Hui, Kwok Fai; Fong, Wing Chi; Ip, Chun Tak; Lui, Hiu Tung Colin

    2016-08-01

    To identify predictors of poor clinical outcome in patients presenting to the intensive care units with status epilepticus (SE), in particular for patients presenting with de novo status epileptics. A retrospective review was performed on patients admitted to the intensive care units with status epilepticus in two hospitals in Hong Kong over an 11-year period from 2003 to 2013. A total of 87 SE cases were analyzed. The mean age of patients was 49.3 years (SD 14.9 years). Eighteen subjects (20.7%) had breakthrough seizure, which was the most common etiology for the status epilepticus episodes. Seventy-eight subjects (89.7%) had convulsive status epilepticus (CSE) and 9 subjects (10.3%) had non-convulsive status epilepticus (NCSE) on presentation. The 30-day mortality rate of all subjects was 18.4%. Non-convulsive status epilepticus was more common in patients with de novo status epilepticus when compared to those with existing history of epilepsy (15.5% Vs. 0%, p=0.03). Patients with de novo status epilepticus were older (52 Vs 43, p=0.009). De novo status epilepticus was associated with longer status duration (median 2.5 days, IQR 5 days), longer ICU stay (median 7.5 days, IQR 9 days) and poorer outcome (OR 4.15, 95% CI 1.53-11.2). For patients presenting to intensive care units with status epilepticus, those with de novo status epileptics were older and were more likely to develop non-convulsive status epilepticus. De novo status epilepticus was associated with poorer outcome. Continuous EEG monitoring would help identifying NCSE and potentially help improving clinical outcomes. Copyright © 2016 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  17. Patients ≥ 75 years with acute coronary syndrome but without critical epicardial coronary disease: prevalence, characteristics, and outcome

    PubMed Central

    Wong, Vincent; Farah, Ahmed; von Korn, Hubertus; Memisevic, Nedim; Richter, Stefan; Tukhiashvili, Ketevan; Lauer, Bernward; Ohlow, Marc-Alexander

    2015-01-01

    Objective Absence of significant epicardial coronary artery disease (CAD) in patients with acute onset of chest pain and elevation of myocardial necrosis markers is occasionally observed. The aim of this study was to analyse the clinical characteristics and outcome of such patients with advanced age. Methods We retrospectively analysed 4,311 patients with acute onset of chest pain plus necrosis marker elevation. Two hundred and seventy two patients without CAD on angiogram (6.3%) were identified. Out of them, 50 (1.2%) patients ≥ 75 years (Group I) were compared with (1) 222 acute coronary syndrome (ACS) patients without CAD on angiogram < 75 years (Group II), and (2) 610 consecutive patients ≥ 75 years with Non-ST-elevation Myocardial Infarction (NSTEMI) undergoing percutaneous coronary intervention (Group III). Results Group I compared to Group III patients made up for more females (64.0% vs. 49.2%; P < 0.0001), and had more severe anginal symptoms on presentation [Canadian Cardiovascular Society (CCS) class I/II, 26.0% vs. 49.8%; P = 0.02]. Group I patients also had lower troponin levels (0.62 ± 0.8 ng/mL vs. 27 ± 74 ng/mL; P < 0.02), lower leukocyte count (9.4 ± 3.13 × 109 vs. 12 ± 5.1 × 109; P = 0.001) and better preserved left ventricular function (56.7% ± 14.3% vs. 45% ± 11%; P < 0.0001). Event-free survival (cardiac death, myocardial infarction, recurrent angina, and re-hospitalisation) was more frequent in Group I and II patients compared to Group III patients (64.9%, 66.7%, and 41.6%, respectively; P < 0.0001). Conclusions ACS in patients ≥ 75 years without CAD is very infrequent, associated with a (1) similar outcome compared to ACS patients < 75 years without CAD, and (2) significant better outcome compared to NSTEMI patients ≥ 75 years. PMID:25678899

  18. Outcomes after diagnosis of mycosis fungoides and Sézary syndrome before 30 years of age: a population-based study.

    PubMed

    Ai, Weiyun Z; Keegan, Theresa H; Press, David J; Yang, Juan; Pincus, Laura B; Kim, Youn H; Chang, Ellen T

    2014-07-01

    Mycosis fungoides and Sézary syndrome (MF/SS) are rare in children and young adults, and thus the incidence and outcomes in this patient population are not well studied. To assess the incidence and outcomes of MF/SS in patients diagnosed before 30 years of age. Retrospective study of 2 population-based cancer registries-the California Cancer Registry (n = 204) and 9 US cancer registries of the Surveillance, Epidemiology, and End Results program (SEER 9; n = 195)-for patients diagnosed with MF/SS before 30 years of age. Overall survival was calculated by the Kaplan-Meier method. The risk of a second cancer was assessed by calculating the standard incidence ratio (SIR) comparing observed cancer incidence in patients with MF/SS with the expected incidence in the age-, sex-, and race-standardized general population. The incidence of MF/SS is rare before 30 years of age, with an incidence rate of 0.05 per 100,000 persons per year before age 20 years and 0.12 per 100,000 persons per year between ages 20 and 29 years in the California Cancer Registry. At 10 years, patients with MF/SS had an overall survival of 94.3% (95% CI, 89.6%-97.2%) in the California Cancer Registry and 88.9% (95% CI, 82.4%-93.2%) in SEER 9. In SEER 9, there was a significant excess risk of all types of second cancers combined (SIR, 3.40; 95% CI, 1.55-6.45), particularly lymphoma (SIR, 12.86; 95% CI, 2.65-37.59) and melanoma (SIR, 9.31; 95% CI, 8.75-33.62). In the California Cancer Registry, the SIR for risk of all types of second cancers was similar to that in SEER 9 (SIR, 3.45; 95% CI, 0.94-8.83), although not statistically significant. Young patients with MF/SS have a favorable outcome, despite a strong suggestion of an increased risk of second primary cancers. Prolonged follow-up is warranted to definitively assess their risk of developing second cancers in a lifetime.

  19. Electrical tree initiation in polyethylene absorbing Penning gas

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Shimizu, N.; Tohyama, N.; Sato, H.

    1996-12-31

    Ac tree initiation voltage was examined in untreated LDPE, vacuum degassed LDPE and LDPE absorbing He gas (He gas was absorbed after vacuum degassing). The authors have already reported that vacuum degassed LDPE shows much higher tree initiation voltage than untreated one because of absence of oxygen. Therefore they expected that LDPE absorbing He shows the same property with vacuum degassed LDPE. However tree initiation voltage of LDPE absorbing He is as low as that of untreated LDPE. LDPE absorbing Ar gas shows the same tendency. He or Ar gas does not change so much impulse tree initiation voltage. LDPEmore » absorbing He was not well dyed with methylene blue after ac voltage application, which indicates that active oxidation does not occur. Low ac tree initiation voltage in LDPE absorbing He or Ar may be caused by Penning ionization in free volume.« less

  20. Child outcomes and family characteristics 1 year after severe inflicted or noninflicted traumatic brain injury.

    PubMed

    Keenan, Heather T; Runyan, Desmond K; Nocera, Maryalice

    2006-02-01

    To assess outcomes 1 year after severe traumatic brain injury (TBI) among young children and to compare outcomes between children with inflicted versus noninflicted injuries. Prospective cohort study. All North Carolina-resident children who were hospitalized between January 2000 and December 2001 in any of the state's 9 PICUs and who survived a severe TBI that occurred on or before their second birthday were eligible to participate. Child health status, child use of ancillary medical resources, and family characteristics were determined through maternal caregiver interviews approximately 1 year after injury. Comparisons were made between family characteristics and child outcomes according to injury type. Seventy-two interviews of maternal caregivers were completed among 112 survivors (64.3%). Children with inflicted injuries (n = 41) had worse outcomes than did children with noninflicted injuries (n = 31), as measured with the Pediatric Outcome Performance Category and Stein-Jessup Functional Status II (Revised) tools. However, approximately 50% of children with inflicted injuries had only mild deficits or better. Children with inflicted injuries had a higher use of ancillary medical resources. Families caring for the children did not differ substantively, with a large proportion of single, working, minority mothers. Children with inflicted TBIs had worse outcomes than did children with other TBIs 1 year after injury. However, outcomes for these children were better than those reported previously. Many families caring for children after severe TBI are socially disadvantaged. Interventions to improve child outcomes may include enhanced family support.

  1. Self-assembly of highly efficient, broadband plasmonic absorbers for solar steam generation

    PubMed Central

    Zhou, Lin; Tan, Yingling; Ji, Dengxin; Zhu, Bin; Zhang, Pei; Xu, Jun; Gan, Qiaoqiang; Yu, Zongfu; Zhu, Jia

    2016-01-01

    The study of ideal absorbers, which can efficiently absorb light over a broad range of wavelengths, is of fundamental importance, as well as critical for many applications from solar steam generation and thermophotovoltaics to light/thermal detectors. As a result of recent advances in plasmonics, plasmonic absorbers have attracted a lot of attention. However, the performance and scalability of these absorbers, predominantly fabricated by the top-down approach, need to be further improved to enable widespread applications. We report a plasmonic absorber which can enable an average measured absorbance of ~99% across the wavelengths from 400 nm to 10 μm, the most efficient and broadband plasmonic absorber reported to date. The absorber is fabricated through self-assembly of metallic nanoparticles onto a nanoporous template by a one-step deposition process. Because of its efficient light absorption, strong field enhancement, and porous structures, which together enable not only efficient solar absorption but also significant local heating and continuous stream flow, plasmonic absorber–based solar steam generation has over 90% efficiency under solar irradiation of only 4-sun intensity (4 kW m−2). The pronounced light absorption effect coupled with the high-throughput self-assembly process could lead toward large-scale manufacturing of other nanophotonic structures and devices. PMID:27152335

  2. 21 CFR 868.5310 - Carbon dioxide absorber.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Carbon dioxide absorber. 868.5310 Section 868.5310...) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5310 Carbon dioxide absorber. (a) Identification. A carbon dioxide absorber is a device that is intended for medical purposes and that is used in a...

  3. 21 CFR 868.5310 - Carbon dioxide absorber.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Carbon dioxide absorber. 868.5310 Section 868.5310...) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5310 Carbon dioxide absorber. (a) Identification. A carbon dioxide absorber is a device that is intended for medical purposes and that is used in a...

  4. 21 CFR 868.5310 - Carbon dioxide absorber.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Carbon dioxide absorber. 868.5310 Section 868.5310...) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5310 Carbon dioxide absorber. (a) Identification. A carbon dioxide absorber is a device that is intended for medical purposes and that is used in a...

  5. Skin Health Connected to the Use of Absorbent Hygiene Products: A Review.

    PubMed

    Bender, Johanna Karlsson; Faergemann, Jan; Sköld, Maria

    2017-09-01

    Over the past 50 years, absorbent hygiene products such as baby diapers and incontinence products have become essential features of modern day life. Through innovation and enhanced technology, their design, composition and performance have been dramatically upgraded from their early forms, and they have transformed the lives of millions of people, improving their quality of life. Skin health related to the use of absorbent hygiene products has accordingly also greatly improved. Still, the wearing of absorbent hygiene products will affect the skin, and for some users the changes in microclimate, mechanical interactions and the exposure to urine and faeces may result in irritant contact dermatitis, i.e. diaper dermatitis (DD) or incontinence-associated dermatitis (IAD). Babies with developing skin and the elderly with deteriorating skin functions who are the most frequent users of absorbent hygiene products are more vulnerable to the causal factors. Although irritant reactions are the most common, allergic contact dermatitis should be considered if a DD/IAD fails to improve by recommended actions. There is also a connection between IAD and pressure ulcer development of which it is important to be aware. A holistic approach of using high-quality absorbent hygiene products in combination with appropriate skin care will help maintaining good skin health.

  6. Deliberate Self-Harm by under-15-Year-Olds: Characteristics, Trends and Outcome

    ERIC Educational Resources Information Center

    Hawton, Keith; Harriss, Louise

    2008-01-01

    Background: Relatively little information is available about the characteristics and long-term outcome of children and adolescents aged under 15 years who present to general hospitals because of deliberate self-harm (DSH). Method: Information was collected on 710 consecutive under-15-year-olds presenting to a general hospital in central England…

  7. PT-symmetric laser absorber

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Longhi, Stefano

    2010-09-15

    In a recent work, Y. D. Chong et al. [Phys. Rev. Lett. 105, 053901 (2010)] proposed the idea of a coherent perfect absorber (CPA) as the time-reversed counterpart of a laser, in which a purely incoming radiation pattern is completely absorbed by a lossy medium. The optical medium that realizes CPA is obtained by reversing the gain with absorption, and thus it generally differs from the lasing medium. Here it is shown that a laser with an optical medium that satisfies the parity-time (PT) symmetry condition {epsilon}(-r)={epsilon}*(r) for the dielectric constant behaves simultaneously as a laser oscillator (i.e., it canmore » emit outgoing coherent waves) and as a CPA (i.e., it can fully absorb incoming coherent waves with appropriate amplitudes and phases). Such a device can thus be referred to as a PT-symmetric CPA laser. The general amplification or absorption features of the PT CPA laser below lasing threshold driven by two fields are determined.« less

  8. Gold absorbing film for a composite bolometer

    NASA Technical Reports Server (NTRS)

    Dragovan, M.; Moseley, S. H.

    1984-01-01

    The principles governing the design of metal films are reviewed, with attention also given to the choice of metals. A description is then given of the characteristics of a bolometer with a gold absorbing film. It is demonstrated that gold is effective as an absorbing film for a millimeter bolometer operated at 1.5 K. At 1.5 K, gold is significantly better than bismuth since gold has a lower heat capacity for the absorbing film. At 0.3 K, gold and bismuth are both suitable. It is pointed out that at temperatures below 0.3 K, a superconducting absorbing film can have a heat capacity low enough not to dominate the heat capacity of the detector; for this reason, it may give better performance than a nonsuperconducting absorbing film.

  9. Energy absorber for the CETA

    NASA Technical Reports Server (NTRS)

    Wesselski, Clarence J.

    1994-01-01

    The energy absorber that was developed for the CETA (Crew Equipment and Translation Aid) on Space Station Freedom is a metal on metal frictional type and has a load regulating feature that prevents excessive stroking loads from occurring while in operation. This paper highlights some of the design and operating aspects and the testing of this energy absorber.

  10. 21 CFR 868.5310 - Carbon dioxide absorber.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Carbon dioxide absorber. 868.5310 Section 868.5310 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5310 Carbon dioxide absorber. (a) Identification. A carbon dioxide absorber is a devic...

  11. 21 CFR 868.5300 - Carbon dioxide absorbent.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Carbon dioxide absorbent. 868.5300 Section 868.5300 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5300 Carbon dioxide absorbent. (a) Identification. A carbon dioxide absorbent is a...

  12. 21 CFR 868.5300 - Carbon dioxide absorbent.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Carbon dioxide absorbent. 868.5300 Section 868.5300 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5300 Carbon dioxide absorbent. (a) Identification. A carbon dioxide absorbent is a...

  13. 21 CFR 868.5310 - Carbon dioxide absorber.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Carbon dioxide absorber. 868.5310 Section 868.5310 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5310 Carbon dioxide absorber. (a) Identification. A carbon dioxide absorber is a devic...

  14. MMPI-2 profiles 23 years after paediatric mild traumatic brain injury.

    PubMed

    Hessen, Erik; Anderson, Vicki; Nestvold, Knut

    2008-01-01

    Research suggest that post-concussive syndrome after mild traumatic brain injury (mTBI) is more common than chronic cognitive impairment. The aim of this study was to investigate very long-term outcome of subjective complaints after paediatric mTBI. The study was a follow-up 23 years after a prospective head injury study at a general hospital in Norway. Forty-one patients were assessed with the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) 23 years after sustaining mTBI as children. A good overall outcome was found with scores close to the normative mean, average length of education and normal employment rate. However, the children that sustained complicated mTBI showed slightly more pathological scores, typical for mild post-concussive syndrome. The most important predictors of poor outcome were skull fracture and a combination of post-traumatic amnesia > 30 minutes and EEG pathology within 24 hours after TBI. No influence of pre- and post-injury risk factors on current MMPI-2 profiles was evident. The results give support for the notion of potentially differential impact of uncomplicated vs complicated mTBI. The findings suggest that children and adolescents sustaining complicated mTBI may be at risk of developing subtle chronic symptoms typical of post-concussive syndrome.

  15. Short-Term Outcomes Following Hip Fractures in Patients at Least 100 Years Old.

    PubMed

    Manoli, Arthur; Driesman, Adam; Marwin, Rebecca A; Konda, Sanjit; Leucht, Philipp; Egol, Kenneth A

    2017-07-05

    The number of hip fractures is rising as life expectancy increases. As such, the number of centenarians sustaining these fractures is also increasing. The purpose of this study was to determine whether patients who are ≥100 years old and sustain a hip fracture fare worse in the hospital than those who are younger. Using a large database, the New York Statewide Planning and Research Cooperative System (SPARCS), we identified patients who were ≥65 years old and had been treated for a hip fracture over a 12-year period. Data on demographics, comorbidities, and treatment were collected. Three cohorts were established: patients who were 65 to 80 years old, 81 to 99 years old, and ≥100 years old (centenarians). Outcome measures included hospital length of stay, estimated total costs, and in-hospital mortality rates. A total of 168,087 patients with a hip fracture were identified, and 1,150 (0.7%) of them had sustained the fracture when they were ≥100 years old. Centenarians incurred costs and had lengths of stay that were similar to those of younger patients. Despite the similarities, centenarians were found to have a significantly higher in-hospital mortality rate than the younger populations (7.4% compared with 4.4% for those 81 to 99 years old and 2.6% for those 65 to 80 years old; p < 0.01). Male sex and an increasing number of medical comorbidities were found to predict in-hospital mortality for centenarians sustaining extracapsular hip fractures. No significant predictors of in-hospital mortality were identified for centenarians who sustained femoral neck fractures. An increased time to surgery did not influence the odds of in-hospital mortality. Centenarians had increased in-hospital mortality, but the remaining short-term outcomes were comparable with those for the younger cohorts with similar fracture patterns. For this extremely elderly population, time to surgery does not appear to affect short-term mortality rates, suggesting a potential benefit to

  16. Is the radiographic subsidence of stand-alone cages associated with adverse clinical outcomes after cervical spine fusion? An observational cohort study with 2-year follow-up outcome scoring.

    PubMed

    Zajonz, Dirk; Franke, Anne-Catherine; von der Höh, Nicolas; Voelker, Anna; Moche, Michael; Gulow, Jens; Heyde, Christoph-Eckhard

    2014-01-01

    The stand-alone treatment of degenerative cervical spine pathologies is a proven method in clinical practice. However, its impact on subsidence, the resulting changes to the profile of the cervical spine and the possible influence of clinical results compared to treatment with additive plate osteosynthesis remain under discussion until present. This study was designed as a retrospective observational cohort study to test the hypothesis that radiographic subsidence of cervical cages is not associated with adverse clinical outcomes. 33 cervical segments were treated surgically by ACDF with stand-alone cage in 17 patients (11 female, 6 male), mean age 56 years (33-82 years), and re-examined after eight and twenty-six months (mean) by means of radiology and score assessment (Medical Outcomes Study Short Form (MOS-SF 36), Oswestry Neck Disability Index (ONDI), painDETECT questionnaire and the visual analogue scale (VAS)). Subsidence was observed in 50.5% of segments (18/33) and 70.6% of patients (12/17). 36.3% of cases of subsidence (12/33) were observed after eight months during mean time of follow-up 1. After 26 months during mean time of follow-up 2, full radiographic fusion was seen in 100%. MOS-SF 36, ONDI and VAS did not show any significant difference between cases with and without subsidence in the two-sample t-test. Only in one type of scoring (painDETECT questionnaire) did a statistically significant difference in t-Test emerge between the two groups (p = 0.03; α = 0.05). However, preoperative painDETECT score differ significantly between patients with subsidence (13.3 falling to 12.6) and patients without subsidence (7.8 dropped to 6.3). The radiological findings indicated 100% healing after stand-alone treatment with ACDF. Subsidence occurred in 50% of the segments treated. No impact on the clinical results was detected in the medium-term study period.

  17. Low back pain: conservative treatment with artificial shock absorbers.

    PubMed

    Wosk, J; Voloshin, A S

    1985-03-01

    A new method of conservative treatment for low back pain (LBP) was studied by follow-up investigation of 382 patients during the last five years. The attempt to reduce repetitive impulsive intervertebral impact in the troublesome S1-L5-4 area by significant improvement of the foot's attenuational capacity through artificial viscoelastic shock absorbing was prompted by the authors' work on decreased capability of LBP spines to attenuate axially propagated walking stresses. Viscoelastic shoe inserts were used in addition to light flexible shoes as artificial shock absorbing devices. Maximal amplitudes of bone oscillation during walking were reduced by about 40% by the viscoelastic inserts. Rapid and surprisingly significant improvement of pain syndrome and patient mobility occurred in about 80% of the patients. The accelerographic patterns recorded on a sacrum of patient with LBP were unusual for a healthy subject; they usually disappeared after treatment in LBP cases. Results suggested that poor walking impact attenuation was a true cause for prolonging intervertebral structures overstrain and consequent degeneration. It seemed logical that as spine damage could be explained primarily by prolonged impulsive overstrain, treatment must include viscoelastic inserts which increase foot shock absorbing capacity and help cushion the spine.

  18. Cognitive outcome and reliable change indices two years following bilateral subthalamic nucleus deep brain stimulation.

    PubMed

    Williams, Amy E; Arzola, Gladys Marina; Strutt, Adriana M; Simpson, Richard; Jankovic, Joseph; York, Michele K

    2011-06-01

    Subthalamic nucleus deep brain stimulation (STN-DBS) is currently the treatment of choice for medication-resistant levodopa-related motor complications in patients with Parkinson's disease (PD). While STN-DBS often results in meaningful motor improvements, consensus regarding long-term neuropsychological outcome continues to be debated. We assessed the cognitive outcomes of 19 STN-DBS patients compared to a group of 18 medically-managed PD patients on a comprehensive neuropsychological battery at baseline and two years post-surgery. Patients did not demonstrate changes in global cognitive functioning on screening measures. However, neuropsychological results revealed impairments in nonverbal recall, oral information processing speed, and lexical and semantic fluency in STN-DBS patients compared to PD controls 2 years post-surgery in these preliminary analyses. Additionally, reliable change indices revealed that approximately 50% of STN-DBS patients demonstrated significant declines in nonverbal memory and oral information processing speed compared to 25-30% of PD controls, and 26% of STN-DBS patients declined on lexical fluency compared to 11% of PD patients. Approximately 30% of both groups declined on semantic fluency. The number of STN-DBS patients who converted to dementia 2 years following surgery was not significantly different from the PD participants (32% versus 16%, respectively). Our results suggest that neuropsychological evaluations may identify possible mild cognitive changes following surgery. Copyright © 2011 Elsevier Ltd. All rights reserved.

  19. Long-term (11+years) outcomes in weight, patient satisfaction, comorbidities, and gastroesophageal reflux treatment after laparoscopic sleeve gastrectomy.

    PubMed

    Arman, Gustavo A; Himpens, Jacques; Dhaenens, Jeroen; Ballet, Thierry; Vilallonga, Ramon; Leman, Guido

    2016-12-01

    More than 10 years of outcomes for sleeve gastrectomy (LSG) have not yet been documented. Analysis of>11 years of outcomes of isolated LSG in terms of progression of weight, patient satisfaction, and evolution of co-morbidities and gastroesophageal reflux disease (GERD) treatment. Two European private hospitals. Chart review and personal interview in consecutive patients who underwent primary isolated LSG (2001-2003). Of the 110 consecutive patients, complete follow-up data was available in 65 (59.1%). Mean follow-up was 11.7±.4 years. Two patients had died of non-procedure-related causes. Twenty (31.7%) patients required 21 reoperations: 14 conversions (10 duodenal switch (DS), 4 Roux-en-Y gastric bypass (RYGB), and 3 resleeve procedures) for weight issues and 2 conversions (RYGB), and 2 hiatoplasties for gastroesophageal reflux disease (GERD). For the 47 (74.6%) individuals who thus kept the simple sleeve construction, percentage of excess body mass index loss (%EBMIL) at 11+years was 62.5%, versus 81.7% (P = .015) for the 16 patients who underwent conversion to another construction. Mean %EBMIL for the entire cohort was 67.4%. At 11+years postoperatively, 30 patients versus 28 preoperatively required treatment for co-morbidities. None of the 7 patients preoperatively suffering from GERD were cured by the LSG procedure. Nine additional patients developed de novo GERD. Overall satisfaction rate was 8 (interquartile range 2) on a scale of 0-10. Isolated LSG provides a long-term %EBMIL of 62.5%. Conversion to another construction, required in 25% of the cases, provides a %EBMIL of 81.7% (P = .015). Patient satisfaction score remains good despite unfavorable GERD outcomes. Copyright © 2016 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  20. Three-year outcomes of root canal treatment: Mining an insurance database.

    PubMed

    Raedel, Michael; Hartmann, Andrea; Bohm, Steffen; Walter, Michael H

    2015-04-01

    There is doubt whether success rates of root canal treatments reported from clinical trials are achievable outside of standardized study populations. The aim of this study was to analyse the outcome of a large number of root canal treatments conducted in general practice. The data was collected from the digital database of a major German national health insurance company. All teeth with complete treatment data were included. Only patients who had been insurance members for the whole 3-year period from 2010 to 2012 were eligible. Kaplan-Meier survival analyses were conducted based on completed root canal treatments. Target events were re-interventions as (1) retreatment of the root canal treatment, (2) apical root resection (apicoectomy) and (3) extraction. The influences of vitality status and root numbers on survival were tested with the log-rank test. A total of 556,067 root canal treatments were included. The cumulative overall survival rate for all target events combined was 84.3% for 3 years. The survival rate for nonvital teeth (82.6%) was significantly lower than for vital teeth (85.6%; p<0.001). The survival rate for single rooted teeth (83.4%) was significantly lower than for multi-rooted teeth (85.5%; p<0.001). The most frequent target event was extraction followed by apical root resection and retreatment. Based on these 3-year outcomes, root canal treatment is considered a reliable treatment in practice routine under the conditions of the German national health insurance system. Root canal treatment can be considered as a reliable treatment option suitable to salvage most of the affected teeth. This statement applies to treatments that in the vast majority of cases were delivered by general practitioners under the terms and conditions of a nationwide health insurance system. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. Environmental Volunteering and Health Outcomes over a 20-Year Period

    PubMed Central

    Pillemer, Karl; Fuller-Rowell, Thomas E.; Reid, M. C.; Wells, Nancy M.

    2010-01-01

    Purpose: This study tested the hypothesis that volunteering in environmental organizations in midlife is associated with greater physical activity and improved mental and physical health over a 20-year period.  Design and Methods: The study used data from two waves (1974 and 1994) of the Alameda County Study, a longitudinal study of health and mortality that has followed a cohort of 6,928 adults since 1965. Using logistic and multiple regression models, we examined the prospective association between environmental and other volunteerism and three outcomes (physical activity, self-reported health, and depression), with 1974 volunteerism predicting 1994 outcomes, controlling for a number of relevant covariates.  Results: Midlife environmental volunteering was significantly associated with physical activity, self-reported health, and depressive symptoms.  Implications: This population-based study offers the first epidemiological evidence for a significant positive relationship between environmental volunteering and health and well-being outcomes. Further research, including intervention studies, is needed to confirm and shed additional light on these initial findings. PMID:20172902

  2. Shock absorber operates over wide range

    NASA Technical Reports Server (NTRS)

    Creasy, W. K.; Jones, J. C.

    1965-01-01

    Piston-type hydraulic shock absorber, with a metered damping system, operates over a wide range of kinetic energy loading rates. It is used for absorbing shock and vibration on mounted machinery and heavy earth-moving equipment.

  3. Dysthymic Disorder and Double Depression: Prediction of 10-Year Course Trajectories and Outcomes

    PubMed Central

    Klein, Daniel N.; Shankman, Stewart A.; Rose, Suzanne

    2008-01-01

    We sought to identify baseline predictors of 10-year course trajectories and outcomes in patients with dysthymic disorder and double depression. Eighty-seven outpatients with early-onset (< 21 years) dysthymic disorder, with or without superimposed major depression, were assessed five times at 30-month intervals for 10 years. Baseline evaluations included semi-structured diagnostic interviews for Axis I and II psychopathology and childhood adversity. Direct interview and family history data were collected on first-degree relatives. Follow-up assessments included the Longitudinal Follow-up Evaluation and Hamilton Depression Rating Scale. Using mixed effects growth curve models, univariate predictors of depression severity and functional impairment at 10-year outcome included older age, less education, concurrent anxiety disorder, greater familial loading for chronic depression, a history of a poorer maternal relationship in childhood, and a history of childhood sexual abuse. In addition, longer duration of dysthymic disorder also predicted greater impairment 10 years later. Predictors of a poorer trajectory of depressive symptoms over time included ethnicity and personality disorders; predictors of a poorer trajectory of social functioning included familial loading of chronic depression and quality of the childhood maternal relationship. Thus, demographic, clinical, family history, and early adversity variables all contribute to predicting the long term trajectory and outcome of DD. These variables should be routinely assessed in clinical evaluations and can provide clinicians with valuable prognostic information. PMID:17466334

  4. Dysthymic disorder and double depression: prediction of 10-year course trajectories and outcomes.

    PubMed

    Klein, Daniel N; Shankman, Stewart A; Rose, Suzanne

    2008-04-01

    We sought to identify baseline predictors of 10-year course trajectories and outcomes in patients with dysthymic disorder and double depression. Eighty-seven outpatients with early-onset (<21 years) dysthymic disorder, with or without superimposed major depression, were assessed five times at 30-month intervals for 10 years. Baseline evaluations included semi-structured diagnostic interviews for Axis I and II psychopathology and childhood adversity. Direct interview and family history data were collected on first-degree relatives. Follow-up assessments included the Longitudinal Follow-up Evaluation and Hamilton Depression Rating Scale. Using mixed effects growth curve models, univariate predictors of depression severity and functional impairment at 10-year outcome included older age, less education, concurrent anxiety disorder, greater familial loading for chronic depression, a history of a poorer maternal relationship in childhood, and a history of childhood sexual abuse. In addition, longer duration of dysthymic disorder also predicted greater impairment 10 years later. Predictors of a poorer trajectory of depressive symptoms over time included ethnicity and personality disorders; predictors of a poorer trajectory of social functioning included familial loading of chronic depression and quality of the childhood maternal relationship. Thus, demographic, clinical, family history, and early adversity variables all contribute to predicting the long-term trajectory and outcome of DD. These variables should be routinely assessed in clinical evaluations and can provide clinicians with valuable prognostic information.

  5. Laminated and Two-Dimensional Carbon-Supported Microwave Absorbers Derived from MXenes.

    PubMed

    Han, Meikang; Yin, Xiaowei; Li, Xinliang; Anasori, Babak; Zhang, Litong; Cheng, Laifei; Gogotsi, Yury

    2017-06-14

    Microwave absorbers with layered structures that can provide abundant interfaces are highly desirable for enhancing electromagnetic absorbing capability and decreasing the thickness. The atomically thin layers of two-dimensional (2D) transition-metal carbides (MXenes) make them a convenient precursor for synthesis of other 2D and layered structures. Here, laminated carbon/TiO 2 hybrid materials composed of well-aligned 2D carbon sheets with embedded TiO 2 nanoparticles were synthesized and showed excellent microwave absorption. Disordered 2D carbon layers with an unusual structure were obtained by annealing multilayer Ti 3 C 2 MXene in a CO 2 atmosphere. The minimum reflection coefficient of laminated carbon/TiO 2 composites reaches -36 dB, and the effective absorption bandwidth ranges from 3.6 to 18 GHz with the tunable thickness from 1.7 to 5 mm. The effective absorption bandwidth covers the whole Ku band (12.4-18 GHz) when the thickness of carbon/TiO 2 /paraffin composite is 1.7 mm. This study is expected to pave the way to the synthesis of carbon-supported absorbing materials using a large family of 2D carbides.

  6. Multi-Level Experimental and Analytical Evaluation of Two Composite Energy Absorbers

    NASA Technical Reports Server (NTRS)

    Jackson, Karen E.; Littell, Justin D.; Fasanella, Edwin L.; Annett, Martin S.; Seal, Michael D., II

    2015-01-01

    Two composite energy absorbers were developed and evaluated at NASA Langley Research Center through multi-level testing and simulation performed under the Transport Rotorcraft Airframe Crash Testbed (TRACT) research program. A conical-shaped energy absorber, designated the conusoid, was evaluated that consisted of four layers of hybrid carbon-Kevlar plain weave fabric oriented at [+45 deg/-45 deg/-45 deg/+45 deg] with respect to the vertical, or crush, direction. A sinusoidal-shaped energy absorber, designated the sinusoid, was developed that consisted of hybrid carbon-Kevlar plain weave fabric face sheets, two layers for each face sheet oriented at +/-45deg with respect to the vertical direction and a closed-cell ELFOAM P200 polyisocyanurate (2.0-lb/cu ft) foam core. The design goal for the energy absorbers was to achieve average floor-level accelerations of between 25- and 40-g during the full-scale crash test of a retrofitted CH-46E helicopter airframe, designated TRACT 2. Variations in both designs were assessed through dynamic crush testing of component specimens. Once the designs were finalized, subfloor beams of each configuration were fabricated and retrofitted into a barrel section of a CH-46E helicopter. A vertical drop test of the barrel section was conducted onto concrete to evaluate the performance of the energy absorbers prior to retrofit into TRACT 2. The retrofitted airframe was crash tested under combined forward and vertical velocity conditions onto soil, which is characterized as a sand/clay mixture. Finite element models were developed of all test articles and simulations were performed using LS-DYNA, a commercial nonlinear explicit transient dynamic finite element code. Test-analysis results are presented for each energy absorber as comparisons of time-history responses, as well as predicted and experimental structural deformations and progressive damage under impact loading for each evaluation level.

  7. Effect on Patient-Reported Outcomes of Debridement or Microfracture of Concomitant Full-Thickness Cartilage Lesions in Anterior Cruciate Ligament-Reconstructed Knees: A Nationwide Cohort Study From Norway and Sweden of 357 Patients With 2-Year Follow-up.

    PubMed

    Røtterud, Jan Harald; Sivertsen, Einar Andreas; Forssblad, Magnus; Engebretsen, Lars; Årøen, Asbjørn

    2016-02-01

    The treatment of concomitant cartilage lesions in anterior cruciate ligament (ACL)-injured knees is debatable. To evaluate the effect of debridement or microfracture (MF) compared with no treatment of concomitant full-thickness (International Cartilage Repair Society [ICRS] grades 3-4) cartilage lesions on patient-reported outcomes after ACL reconstruction. Cohort study; Level of evidence, 2. Six hundred forty-four patients who underwent primary unilateral ACL reconstruction and had a concomitant full-thickness cartilage lesion treated simultaneously by debridement (n = 129) or MF (n = 164), or underwent no treatment (n = 351) of the cartilage lesion, registered in the Norwegian and Swedish National Knee Ligament Registries from 2005 to 2008 were included. The Knee Injury and Osteoarthritis Outcome Score (KOOS) was used to measure patient-reported outcomes. At a mean follow-up of 2.1 ± 0.2 years after surgery, 357 (55%) patients completed the KOOS. Linear regression analyses were used to evaluate the effect of debridement or MF on the KOOS. No significant effects of debridement were detected in the unadjusted or adjusted regression analyses on any of the KOOS subscales at 2-year follow-up. The MF treatment of the cartilage lesions had significant negative effects at 2-year follow-up on the KOOS Sport and Recreation (Sport/Rec) (regression coefficient [β] = -8.9; 95% confidence interval [CI], -15.1 to -1.5) and Knee-Related Quality of Life (QoL) (β = -8.1; 95% CI, -14.1 to -2.1) subscales in the unadjusted analyses. When adjusting for confounders, MF had significant negative effects on the same KOOS subscales of Sport/Rec (β = -8.6; 95% CI, -16.4 to -0.7) and QoL (β = -7.2; 95% CI, -13.6 to -0.8). For the remaining KOOS subscales of Pain, Symptoms, and Activities of Daily Living, there were no significant unadjusted or adjusted effects of MF. MF of concomitant full-thickness cartilage lesions showed adverse effects on patient-reported outcomes at 2-year follow

  8. Scheduling the blended solution as industrial CO2 absorber in separation process by back-propagation artificial neural networks.

    PubMed

    Abdollahi, Yadollah; Sairi, Nor Asrina; Said, Suhana Binti Mohd; Abouzari-lotf, Ebrahim; Zakaria, Azmi; Sabri, Mohd Faizul Bin Mohd; Islam, Aminul; Alias, Yatimah

    2015-11-05

    It is believe that 80% industrial of carbon dioxide can be controlled by separation and storage technologies which use the blended ionic liquids absorber. Among the blended absorbers, the mixture of water, N-methyldiethanolamine (MDEA) and guanidinium trifluoromethane sulfonate (gua) has presented the superior stripping qualities. However, the blended solution has illustrated high viscosity that affects the cost of separation process. In this work, the blended fabrication was scheduled with is the process arranging, controlling and optimizing. Therefore, the blend's components and operating temperature were modeled and optimized as input effective variables to minimize its viscosity as the final output by using back-propagation artificial neural network (ANN). The modeling was carried out by four mathematical algorithms with individual experimental design to obtain the optimum topology using root mean squared error (RMSE), R-squared (R(2)) and absolute average deviation (AAD). As a result, the final model (QP-4-8-1) with minimum RMSE and AAD as well as the highest R(2) was selected to navigate the fabrication of the blended solution. Therefore, the model was applied to obtain the optimum initial level of the input variables which were included temperature 303-323 K, x[gua], 0-0.033, x[MDAE], 0.3-0.4, and x[H2O], 0.7-1.0. Moreover, the model has obtained the relative importance ordered of the variables which included x[gua]>temperature>x[MDEA]>x[H2O]. Therefore, none of the variables was negligible in the fabrication. Furthermore, the model predicted the optimum points of the variables to minimize the viscosity which was validated by further experiments. The validated results confirmed the model schedulability. Accordingly, ANN succeeds to model the initial components of the blended solutions as absorber of CO2 capture in separation technologies that is able to industries scale up. Copyright © 2015 Elsevier B.V. All rights reserved.

  9. Fetal monitoring indications for delivery and 2-year outcome in 310 infants with fetal growth restriction delivered before 32 weeks' gestation in the TRUFFLE study.

    PubMed

    Visser, G H A; Bilardo, C M; Derks, J B; Ferrazzi, E; Fratelli, N; Frusca, T; Ganzevoort, W; Lees, C C; Napolitano, R; Todros, T; Wolf, H; Hecher, K

    2017-09-01

    In the TRUFFLE (Trial of Randomized Umbilical and Fetal Flow in Europe) study on the outcome of early fetal growth restriction, women were allocated to one of three groups of indication for delivery according to the following monitoring strategies: (1) reduced fetal heart rate (FHR) short-term variation (STV) on cardiotocography (CTG); (2) early changes in fetal ductus venosus (DV) waveform (DV-p95); and (3) late changes in fetal DV waveform (DV-no-A). However, many infants per monitoring protocol were delivered because of safety-net criteria, for maternal or other fetal indications, or after 32 weeks of gestation when the protocol was no longer applied. The objective of the present posthoc subanalysis was to investigate the indications for delivery in relation to 2-year outcome in infants delivered before 32 weeks to further refine management proposals. We included all 310 cases of the TRUFFLE study with known outcome at 2 years' corrected age and seven fetal deaths, excluding seven cases with inevitable perinatal death. Data were analyzed according to the allocated fetal monitoring strategy in combination with the indication for delivery. Overall, only 32% of liveborn infants were delivered according to the specified monitoring parameter for indication for delivery; 38% were delivered because of safety-net criteria, 15% for other fetal reasons and 15% for maternal reasons. In the CTG-STV group, 51% of infants were delivered because of reduced STV. In the DV-p95 group, 34% of infants were delivered because of abnormal DV and, in the DV-no-A group, only 10% of infants were delivered accordingly. The majority of infants in the DV groups were delivered for the safety-net criterion of spontaneous decelerations in FHR. Two-year intact survival was highest in the DV groups combined compared with the CTG-STV group (P = 0.05 for live births only, P = 0.21 including fetal death), with no difference between DV groups. A poorer outcome in the CTG-STV group was restricted to

  10. I Wish I Had (Not) Taken a Gap-Year? The Psychological and Attainment Outcomes of Different Post-School Pathways

    ERIC Educational Resources Information Center

    Parker, Philip D.; Thoemmes, Felix; Duineveld, Jasper J.; Salmela-Aro, Katariina

    2015-01-01

    Existing gap-year research indicates a number of benefits of a gap-year at the end of school and before university enrollment. Life span theory of control, however, suggests that direct goal investment, rather than delay, at developmental transitions is associated with more adaptive outcomes. Comparing these perspectives, the authors undertook 2

  11. Pregnancy outcomes in women aged 35 years or older with gestational diabetes - a registry-based study in Finland.

    PubMed

    Lamminpää, Reeta; Vehviläinen-Julkunen, Katri; Gissler, Mika; Selander, Tuomas; Heinonen, Seppo

    2016-01-01

    To compare pregnancy outcomes of women ≥ 35 years to women <35 years with and without gestational diabetes. The data include 230,003 women <35 years and 53,321 women ≥ 35 years and their newborns from 2004 to 2008. In multivariate modeling, the main outcome measures were preterm delivery (<28, 28-31 and 32-36 weeks' gestation), Apgar scores <7 at 5 min, small for gestational age (SGA), fetal death, asphyxia, preeclampsia, admission to neonatal intensive care unit (NICU), shoulder dystocia and large for gestational age (LGA). In comparison to women <35 with normal glucose tolerance, preeclampsia (OR 1.57, CI 1.30-1.88), admission to the NICU (OR 3.30, CI 2.94-3.69) and shoulder dystocia (OR 2.12, CI 1.05-4.30) were highest in insulin-treated women ≥ 35 years. In women ≥35, diet- and insulin-treated gestational diabetes mellitus (GDM) increased the rates of preeclampsia, shoulder dystocia and admission to NICU (OR 3.07 CI 2.73-3.45). The effect of advanced maternal age was observed in very preterm delivery (<28 weeks), fetal death, preeclampsia and NICU. The increase in preeclampsia was statistically significant. GDM at advanced age is a high risk state and, more specifically, the risk caused by age and GDM appear to be increasing in preeclampsia.

  12. Performance evaluation of CFRP-rubber shock absorbers

    NASA Astrophysics Data System (ADS)

    Lamanna, Giuseppe; Sepe, Raffaele

    2014-05-01

    In the present work a numerical investigation on the energy absorbing capability of dedicated structural components made of a carbon fiber reinforced polymer and an emulsion polymerised styrene butadiene rubber is reported. The shock absorbers are devices designed to absorb large amounts of energy by sacrificing their own structural integrity. Their aim is to cushion the effects of an impact phenomenon with the intent to preserve other structures from global failure or local damaging. Another important role of shock absorbers is reducing the peak of the acceleration showed during an impact phenomenon. This effect is of considerable interest in the case of vehicles to preserve passengers' safety. Static and dynamic numerical results are compared with experimental ones in terms of mean crushing forces, energy and peak crushing. The global performance of the absorbers has been evaluated by referencing to a proposed quality index.

  13. [Occupational outcome of patients with schizophrenia after first request for disability status: a 2-year follow-up study].

    PubMed

    Verdoux, H; Goumilloux, R; Monello, F; Cougnard, A

    2010-12-01

    To assess occupational outcome of persons with schizophrenia over the 2 years following the first request of disability status. This study was carried out in collaboration with the Commission Technique d'Orientation et de Reclassement Professionnel (COTOREP) (technical commission for occupational guidance and rehabilitation of the disabled) de la Gironde (Bordeaux region, South Western France). Persons with schizophrenia or schizoaffective disorder requesting for the first time in 2006 a disability allowance or the status of disabled worker were assessed using a standardized questionnaire collecting data on clinical, occupational and income history. Information on occupational outcome over the 2 years after the first request was collected at the end of the follow-up using multiple sources of information. We used a broad definition of work, including moonlighting and episodic activities (baby-sitting or grape-harvesting), as well as study periods. Of the 121 patients included at baseline, direct or indirect information was available for 108 (90%) at the 24-month assessment. Persons lost to follow-up were less likely to have worked before first request of disability status compared to persons with information available at the end of the follow-up, but did not differ regarding the other characteristics. Nearly half of the persons (41.7%) had worked over the follow-up, irrespective of the type and duration of the occupation. The working periods were of short duration (median duration 14.5 days, interquartile range 6.5-47.5) and most (98%) were done in low-qualified jobs. Nearly half of the persons reported that they had benefitted from support for starting or returning to work, mainly from recruitment agencies specialized in supporting disabled workers. Persons with the status of disabled worker (Reconnaissance de la qualité de travailleur handicapé) (RTH) were more likely to have worked over the follow-up period (66.7% vs 33.3%; OR=3.9; 95%IC 1.3-11.3; p<0.01) as

  14. Development of a primary standard for absorbed dose from unsealed radionuclide solutions

    NASA Astrophysics Data System (ADS)

    Billas, I.; Shipley, D.; Galer, S.; Bass, G.; Sander, T.; Fenwick, A.; Smyth, V.

    2016-12-01

    dose assessment methods based on MIRD and RADAR data for 90Y have been validated with experimental absorbed dose determination and they agree within the stated expanded uncertainty (k  =  2).

  15. Overlapping bio-absorbable scaffolds: Aim for D2D technique?

    PubMed

    Khan, Asaad A; Dangas, George D

    2018-06-01

    The results of overlapping metallic stents have been concerning but this practice is often unavoidable in the setting of long or tortuous lesions, diameter discrepancy of proximal and distal vessel, and for residual dissections. Theoretically, bio-absorbable scaffolds may carry an advantage over metallic stents due to the progressive resorption of the scaffold theoretically rendering the overlap a non-issue; this has not been clinically evident. Since stent/scaffold overlap cannot be entirely avoided, improved stent delivery/deployment and scaffold design modification may reduce complications in this complex patient subset. © 2018 Wiley Periodicals, Inc.

  16. Transition metal dichalcogenide (WS2 and MoS2) saturable absorbers for Q-switched Er-doped fiber lasers

    NASA Astrophysics Data System (ADS)

    Li, Lu; Lv, Ruidong; Liu, Sicong; Wang, Xi; Wang, Yonggang; Chen, Zhendong; Wang, Jiang

    2018-05-01

    This report demonstrates a stable Q-switched Er-doped fiber laser with MoS2 (WS2)-based saturable absorber (SA) in the net normal dispersion regime. The SA is obtained by mixing MoS2 (WS2) nanosheets with polyvinyl alcohol (PVA) into polystyrene cells, and then evaporating them to form MoS2 (WS2)/PVA film. The modulation depth values for MoS2/PVA and WS2/PVA are measured to be 2.7% and 2.1% respectively. Employing the MoS2 (WS2)/PVA film in the Er-doped fiber laser cavity, stable Q-switching operation is achieved with central wavelength of 1560 nm. The shortest pulse durations of the two Q-switched fiber lasers are, respectively, 3.97 and 3.71 µs, and their maximum single pulse energies are measured to be 131.52 and 126.96 nJ. The experimental results clearly show that MoS2 (WS2) is a promising nonlinear material, and that improvements in Q-switching performance due to two SAs in the net normal dispersion regime might be helpful in the design of fiber lasers.

  17. Predictors of outcomes of assertive outreach teams: a 3-year follow-up study in North East England.

    PubMed

    Carpenter, John; Luce, Anna; Wooff, David

    2011-06-01

    Assertive outreach (AO) is a required component of services for people with severe mental illness in England. However, the claims to its effectiveness have been contested and the relationships between team organisation, including model fidelity, the use of mental health interventions and outcomes for service users remain unclear. Three-year follow up of 33 AO teams was conducted using standardised measures of model fidelity and mental health interventions, and of current location and a range of outcomes for service users (n = 628). Predictors of the number of hospital admissions, mental health and social functioning at T2, and discharge from the team as 'improved' were modelled using multivariate regression analyses. Teams had moderate mean ratings of fidelity to the AO model. All rated highly on the core intervention modalities of engagement, assessment and care co-ordination, but ratings for psychosocial interventions were comparatively low. Two-thirds (462) of service users were still in AO and data were returned on 400 (87%). There was evidence of small improvements in mental health and social functioning and a reduction in the mean number of hospital admissions in the previous 2 years (from 2.09 to 1.39). Poor outcomes were predicted variously by service users' characteristics, previous psychiatric history, poor collaboration with services, homelessness and dual diagnosis. Fidelity to the AO model did not emerge as a predictor of outcome, but the team working for extended hours was associated with more frequent in-patient admissions and less likelihood of discharge from AO. Supportive interventions in daily living, together with the team's use of family and psychological interventions were also associated with poorer outcomes. Possible explanations for these unexpected findings are considered. AO appears to have been quite successful in keeping users engaged over a substantial period and to have an impact in supporting many people to live in the community and

  18. Group cognitive behavioral therapy for patients with generalized social anxiety disorder in Japan: outcomes at 1-year follow up and outcome predictors

    PubMed Central

    Kawaguchi, Akiko; Watanabe, Norio; Nakano, Yumi; Ogawa, Sei; Suzuki, Masako; Kondo, Masaki; Furukawa, Toshi A; Akechi, Tatsuo

    2013-01-01

    Background Social anxiety disorder (SAD) is one of the most common psychiatric disorders worldwide. Cognitive behavioral therapy (CBT) is an effective treatment option for patients with SAD. In the present study, we examined the efficacy of group CBT for patients with generalized SAD in Japan at 1-year follow-up and investigated predictors with regard to outcomes. Methods This study was conducted as a single-arm, naturalistic, follow-up study in a routine Japanese clinical setting. A total of 113 outpatients with generalized SAD participated in group CBT from July 2003 to August 2010 and were assessed at follow-ups for up to 1 year. Primary outcome was the total score on the Social Phobia Scale/Social Interaction Anxiety Scale (SPS/SIAS) at 1 year. Possible baseline predictors were investigated using mixed-model analyses. Results Among the 113 patients, 70 completed the assessment at the 1-year follow-up. The SPS/SIAS scores showed significant improvement throughout the follow-ups for up to 1 year. The effect sizes of SPS/SIAS at the 1-year follow-up were 0.68 (95% confidence interval 0.41–0.95)/0.76 (0.49–1.03) in the intention-to-treat group and 0.77 (0.42–1.10)/0.84 (0.49–1.18) in completers. Older age at baseline, late onset, and lower severity of SAD were significantly associated with good outcomes as a result of mixed-model analyses. Conclusions CBT for patients with generalized SAD in Japan is effective for up to 1 year after treatment. The effect sizes were as large as those in previous studies conducted in Western countries. Older age at baseline, late onset, and lower severity of SAD were predictors for a good outcome from group CBT. PMID:23450841

  19. Adult scoliosis in patients over sixty-five years of age: outcomes of operative versus nonoperative treatment at a minimum two-year follow-up.

    PubMed

    Li, Gang; Passias, Peter; Kozanek, Michal; Fu, Eric; Wang, Shaobai; Xia, Qun; Li, Guoan; Rand, Frank E; Wood, Kirkham B

    2009-09-15

    Retrospective case-control study. The purpose of this study was to compare the self-reported outcomes between operatively and nonoperatively treated patients over the age of 65 with adult scoliosis, using 4 distinct self-assessment questionnaires (SRS-22, SF-12, EQ5D, and Oswestry disability index [ODI]) and standard radiographic measurement parameters. The current spine literature contains no studies that directly compare the self-reported and radiographic outcomes of operatively and nonoperatively treated patients over the age of 65 years with adult scoliosis. We retrospectively analyzed the self-reported outcomes of 83 adult scoliosis in patients over the age of 65 years. A total of 34 patients were treated operatively, whereas 49 patients were managed nonoperatively. For each of these patients, standard radiographic measurements were recorded both before and after treatment, and each patient received 4 questionnaires (SRS-22, SF-12, EQ5D, and ODI) that were completed with a minimum of 2-year follow-up from the time the treatment was initiated. The outcomes of both groups were then statistically compared. As compared to the nonoperative group, the operative group reported significantly better self-assessment scores for the EQ5D index, EQ5D Visual Analogue Score, and SRS-22 questionnaires. However, no statistically significant difference between the groups was detected for the ODI, SF-12 Mental Health Component Summary, and SF-12 PCS. Furthermore, the operative group also had a significant improvement in radiographic measurements. Adult scoliosis patients over the age of 65 years treated operatively had significantly less pain, a better health-related quality of life, self image, mental health, and were more satisfied with their treatment than patients treated conservatively. However, we found no statistically significant differences in their degree of disability as measured by the ODI as well as physical and mental health by the SF-12 instrument. Preoperative

  20. Child Outcomes and Family Characteristics 1 Year After Severe Inflicted or Noninflicted Traumatic Brain Injury

    PubMed Central

    Keenan, Heather T.; Runyan, Desmond K.; Nocera, Maryalice

    2008-01-01

    OBJECTIVE To assess outcomes 1 year after severe traumatic brain injury (TBI) among young children and to compare outcomes between children with inflicted versus noninflicted injuries. STUDY DESIGN Prospective cohort study. METHODS All North Carolina-resident children who were hospitalized between January 2000 and December 2001 in any of the state’s 9 PICUs and who survived a severe TBI that occurred on or before their second birthday were eligible to participate. Child health status, child use of ancillary medical resources, and family characteristics were determined through maternal caregiver interviews ~1 year after injury. Comparisons were made between family characteristics and child outcomes according to injury type. RESULTS Seventy-two interviews of maternal caregivers were completed among 112 survivors (64.3%). Children with inflicted injuries (n = 41) had worse outcomes than did children with noninflicted injuries (n = 31), as measured with the Pediatric Outcome Performance Category and Stein-Jessup Functional Status II (Revised) tools. However, ~50% of children with inflicted injuries had only mild deficits or better. Children with inflicted injuries had a higher use of ancillary medical resources. Families caring for the children did not differ substantively, with a large proportion of single, working, minority mothers. CONCLUSIONS Children with inflicted TBIs had worse outcomes than did children with other TBIs 1 year after injury. However, outcomes for these children were better than those reported previously. Many families caring for children after severe TBI are socially disadvantaged. Interventions to improve child outcomes may include enhanced family support. PMID:16452349